Elevated Troponin I (≥ 136.5 pg/ml) was independently associated with myocardial inflammation (OR 3.011) in patients with non-ischemic heart failure.
Observational (n=397)
No
Do elevated CRP, TnI, and GLS predict myocardial inflammation in patients with non-ischemic heart failure?
Elevated CRP, Troponin I, and Global Longitudinal Strain can help identify myocardial inflammation in patients with non-ischemic heart failure, potentially reducing the need for biopsy.
Effect estimate: OR 3.011 (95% CI 1.215-7.464)
p-value: p=0.017
Abstract Inflammatory cardiomyopathy diagnosed by endomyocardial biopsy (EMB) is common in non-ischemic heart failure (HF) and might be associated with adverse outcome. We aimed to identify markers predicting myocardial inflammation in HF. We screened 517 patients with symptomatic non-ischemic HF who underwent EMB; 397 patients (median age 54 IQR 43/64, 28.7% females) were included in this study. 230 patients were diagnosed with myocardial inflammation, defined as ≥ 7.0 CD3 + lymphocytes/mm 2 and/or ≥ 35.0 Mac1 macrophages/mm 2 and were compared to 167 inflammation negative patients. Patients with myocardial inflammation were more often smokers (52.4% vs. 39.8%, p = 0.013) and had higher C-reactive protein (CRP) levels (5.4 mg/dl vs. 3.7 mg/dl, p = 0.003). In logistic regression models CRP ≥ 8.15 mg/dl (OR 1.985 95%CI 1.160–3.397; p = 0.012) and Troponin I (TnI) ≥ 136.5 pg/ml (OR 3.011 1.215–7.464; p = 0.017) were independently associated with myocardial inflammation, whereas no association was found for elevated brain natriuretic peptide (OR 1.811 0.873–3.757; p = 0.111). In prognostic performance calculation the highest positive predictive value (90%) was detected for the combination of Global longitudinal strain (GLS) ≥ -13.95% and TnI ≥ 136.5 pg/ml (0.90 (0.74–0.96)). Elevated CRP, TnI and GLS in combination with TnI can be useful to detect myocardial inflammation. Smoking seems to predispose for myocardial inflammation.
Schwuchow‐Thonke et al. (Thu,) conducted a observational in non-ischemic heart failure (n=397). Elevated Troponin I (≥ 136.5 pg/ml) vs. Troponin I < 136.5 pg/ml was evaluated on Myocardial inflammation (≥ 7.0 CD3+ lymphocytes/mm2 and/or ≥ 35.0 Mac1 macrophages/mm2) (OR 3.011, 95% CI 1.215-7.464, p=0.017). Elevated Troponin I (≥ 136.5 pg/ml) was independently associated with myocardial inflammation (OR 3.011) in patients with non-ischemic heart failure.