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July 3, 2026Journal of the American College of Cardiology197 citations

Cardiac troponin i in acute pericarditis

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MIMassimo ImazioBDBrunella DemichelisECEnrico Cecchi

Key Result

A positive cTnI test in viral or idiopathic acute pericarditis was not associated with an increased rate of recurrent pericarditis compared to a negative test (18.4% vs 18.8%; p=NS).

Key Points

  • To investigate the prognostic value of cardiac troponin I in cases of viral or idiopathic pericarditis.
  • Enrolled 118 consecutive cases within 24 hours of symptom onset.
  • Measured cTnI levels using a highly sensitive enzymoimmunofluorometric method.
  • Analyzed associations of cTnI rise with clinical characteristics and follow-up outcomes.
  • cTnI elevation observed in 38 patients (32.2%).
  • Notable associations with positive cTnI test included younger age (p < 0.001) and male gender (p = 0.007).
  • No significant differences in complications between positive and negative cTnI test groups after 24 months of follow-up.

Study Design

Type

Observational (n=118)

PICO

P
Population
118 consecutive patients with viral or idiopathic acute pericarditis enrolled within 24 hours of symptom onset, followed for a mean of 24 months.
E
Exposure / Comparator
Positive cardiac troponin I (cTnI) test vs Negative cTnI test
O
Primary Outcome
recurrent pericarditis, p=NS

Main Result

Absolute Event Rate: 18.4% vs 18.8%

p-value: p=NS

Abstract

OBJECTIVES: This study was designed to investigate the prognostic value of cardiac troponin I (cTnI) in viral or idiopathic pericarditis. BACKGROUND: Idiopathic acute pericarditis has been recently reported as a possible cause of nonischemic release of cTnI. The prognostic value of this observation remains unknown. METHODS: We enrolled 118 consecutive cases (age 49.2 +/- 18.4 years; 61 men) within 24 h of symptoms onset. A highly sensitive enzymoimmunofluorometric method was used to measure cTnI (acute myocardial infarction AMI threshold was 1.5 ng/ml). RESULTS: A cTnI rise was detectable in 38 patients (32.2%). The following characteristics were more frequently associated with a positive cTnI test: younger age (p < 0.001), male gender (p = 0.007), ST-segment elevation (p < 0.001), and pericardial effusion (p = 0.007) at presentation. An increase beyond AMI threshold was present in nine cases (7.6%), with an associated creatine kinase-MB elevation, a release pattern similar to AMI, and echocardiographic diffuse or localized abnormal left ventricular wall motion without detectable coronary artery disease. After a mean follow-up of 24 months a similar rate of complications was found in patients with a positive or a negative cTnI test (recurrent pericarditis: 18.4 vs. 18.8%; constrictive pericarditis: 0 vs. 1.3%, for all p = NS; no cases of cardiac tamponade or residual left ventricular dysfunction were detected). CONCLUSIONS: In viral or idiopathic acute pericarditis cTnI elevation is frequently observed and commonly associated with young age, male gender, ST-segment elevation, and pericardial effusion at presentation. cTnI increase is roughly related to the extent of myocardial inflammatory involvement and, unlike acute coronary syndromes, is not a negative prognostic marker.

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Cite This Study

Imazio et al. (2003) conducted an observational in viral or idiopathic acute pericarditis (n=118). Positive cardiac troponin I (cTnI) test vs. Negative cTnI test was evaluated on recurrent pericarditis (p=NS). A positive cTnI test in viral or idiopathic acute pericarditis was not associated with an increased rate of recurrent pericarditis compared to a negative test (18.4% vs 18.8%; p=NS).

synapsesocial.com/papers/6a47d2eaad3d0ceaee1001a0https://doi.org/10.1016/j.jacc.2003.02.001
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