{
  "abstract": "Background Raised cardiac troponin-I is a common finding in patients hospitalised with acute viral infections, including but not limited to COVID-19. This often occurs in the absence of overt myocardial injury presenting a challenge for interpretation. The mechanisms underlying troponin elevation are uncertain.Methods The CISCO-19 (Cardiovascular Imaging in SARS-CoV-19) study ( NCT04403607) is a prospective, multicentre cohort study, in which hospitalised PCR-confirmed COVID-19 participants (N=267) underwent multisystem evaluation at enrolment and at 28–60 days. The study incorporated plasma proteomics (SOMAscan V.4.1), cardiovascular MRI and clinical biomarkers. Of these, 211 had baseline plasma proteomic data and 185 completed follow-up sampling. Matched proteomic and imaging data were available for 155 participants (mean age: 55 years (SD 12); 43% female).Results A high likelihood of myocarditis was identified in 13.2% (N=21/159) of participants. High-sensitivity troponin-I was modestly elevated at enrolment (median 3 ng/L; IQR 2–6; n=159). Among males (n=90), 9.3% had a high-sensitivity troponin that exceeded 34 ng/L. Among females (n=69), 4.5% exceeded 16 ng/L. Smooth muscle myosin light chain proteins were downregulated at follow-up (log2 fold change −0.12 to −0.6; all adjusted p<0.02) and positively correlated with high-sensitivity troponin-I, but not N-terminal brain natriuretic peptide or cardiac MRI indices (n=155).Conclusions Troponin elevation, exemplified here by COVID-19, could reflect systemic vascular injury. Recognising this mechanism may refine interpretation of cardiac biomarkers in viral illness and supports the investigation of vascular injury in future therapeutic strategies and biomedical studies.",
  "authors": [
    {
      "affiliations": [
        "Department of Cardiology, Golden Jubilee National Hospital, Clydebank, UK",
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Anna Kamdar"
    },
    {
      "affiliations": [
        "Department of Cardiology, Golden Jubilee National Hospital, Clydebank, UK",
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Daniel Tze Yee Ang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Golden Jubilee National Hospital, Clydebank, UK",
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Kenneth Mangion"
    },
    {
      "affiliations": [
        "Molecular Analysis, Shared Research Facility, University of Glasgow, Glasgow, UK"
      ],
      "name": "David McGuinness"
    },
    {
      "affiliations": [
        "University of Glasgow Robertson Centre for Biostatistics, Glasgow, UK"
      ],
      "name": "Jiyoung Lee"
    },
    {
      "affiliations": [
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Robert Sykes"
    },
    {
      "affiliations": [
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Andrew Morrow"
    },
    {
      "affiliations": [
        "Molecular Analysis, Shared Research Facility, University of Glasgow, Glasgow, UK"
      ],
      "name": "John Cole"
    },
    {
      "affiliations": [
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Paul Welsh"
    },
    {
      "affiliations": [
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Naveed Sattar"
    },
    {
      "affiliations": [
        "University of Glasgow Robertson Centre for Biostatistics, Glasgow, UK"
      ],
      "name": "Alex McConnachie"
    },
    {
      "affiliations": [
        "School of Health and Wellbeing, University of Glasgow, Glasgow, UK"
      ],
      "name": "Jocelyn M Friday"
    },
    {
      "affiliations": [
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Jonathan Berry"
    },
    {
      "affiliations": [
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Laura Dowsett"
    },
    {
      "affiliations": [
        "School of Cancer Sciences, University of Glasgow, Glasgow, UK"
      ],
      "name": "Nigel Jamieson"
    },
    {
      "affiliations": [
        "Department of Cardiology, Golden Jubilee National Hospital, Clydebank, UK",
        "School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK"
      ],
      "name": "Colin Berry"
    }
  ],
  "title": "Proteomic insights into troponin elevation following COVID-19 infection",
  "uid": "574dd639-574f-56e4-8215-cdf450a4e74b"
}