Key result
High levels of NT-proBNP and CRP were significantly associated with increased length of stay (r=0.57, p<0.001) and in-hospital complications, whereas troponin levels were not.
Why the study?
The prognostic yield of NT-proBNP and CRP in acute myocarditis among patients with preserved or mildly reduced LVEF needed evaluation.
Does measurement of NT-proBNP and CRP predict length of stay and complications better than troponin in stable patients with suspected acute myocarditis?
Cohort (n=59)
Does measurement of NT-proBNP and CRP predict length of stay and complications better than troponin in stable patients with suspected acute myocarditis?
Effect estimate: r 0.57
p-value: p=<0.001
Routine measurement of NT-proBNP and CRP may be superior to troponin for risk stratification in hemodynamically stable acute myocarditis.
NT-proBNP and CRP levels were associated with greater severity in acute myocarditis with preserved LVEF; leaves open whether they refine CMR-based risk stratification.
Risk stratification in acute myocarditis is based on the clinical signs of heart failure, the degree of cardiac dysfunction, and the findings in cardiac magnetic resonance (CMR). The aim of the current study is to examine the prognostic yield of the natriuretic peptide N-terminal-pro hormone Brain Natriuretic Peptide (NT-proBNP) and C-reactive protein (CRP) in acute myocarditis among patients with preserved/mildly reduced left ventricular ejection fraction (LVEF). We retrospectively analyzed 59 patients (median age 28 years, 76% males) with ICD-9 discharge diagnosis of acute myocarditis. Basic characteristics, echocardiographic, and laboratory parameters were obtained from computerized files. The median length of stay was 3, (IQR 2−5) days, and the median LVEF was 48% (IQR, 54−62%). High levels of NT-proBNP and CRP were associated with increased length of stay (r = 0.57, p < 0.001; r = 0.4 p = 0.001, respectively), while troponin level was not (r = 0.068, p = 0.61). During the index hospitalization, complications occurred in 14 (23.7%) patients. High NT-proBNP and CRP levels were associated with complications (p < 0.001, and p = 0.001, respectively), while troponin level was not (p = 0.452). In conclusion, routine measurement of NT-proBNP and CRP are preferred over troponin for risk stratification in hemodynamically stable myocarditis.
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Moady et al. (2022) conducted a cohort in Acute myocarditis with preserved/mildly reduced LVEF (n=59). High levels of NT-proBNP and CRP vs. Troponin was evaluated on Length of stay and in-hospital complications (r 0.57, p=<0.001). High levels of NT-proBNP and CRP were significantly associated with increased length of stay (r=0.57, p<0.001) and in-hospital complications, whereas troponin levels were not.