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Background Heart involvement is common in Systemic Sclerosis (SSc), even if often clinically silent, and represent one of the leading cause of death in these patients. Objectives The aim of our study was to define the role of cardiac troponin T (cTnT) and NT-proBNP to identify cardiac involvement in SSc. Methods From 2008 to 2013 high sensitivity cTnT and NT-proBNP were measured in 200 consecutive SSc patients and in 30 sex and aged matched healthy controls. Data regarding disease subtype and organ involvement were available for the entire cohort. All SSc-related deaths were registered. Results cTnT levels and NT-proBNP values were higher in scleroderma patients (cTnT: 0.03±0.006 ng/ml and NT-proBNP: 898.8±3063.8 pg/ml) than in healthy controls (cTnT: 0.006±0.0004 ng/ml and NT-proBNP: 90.6±70.9 pg/ml, p125 pg/ml. Cumulative survival estimated by Kaplan-Mayer curve was worse in patients with increased baseline levels of cTnT and NT-proBNP. Died patients presented higher levels of cTnT (0.11±0.03 ng/ml) and of NT-proBNP (7193.1±5691.6 pg/ml) and lower left ventricular-ejection fraction (LV-EF) (52.5±11.9%) than survivors (cTnT: 0.02±0.05 ng/ml; NT-proBNP: 585.8±2517.3 pg/ml; LV-EF: 61.9±6.6%; p0.019 ng/ml showed the best specificity (75%) with a sensitivity of 100% to identify patients with poor outcome (AUROC=0.90, p618 mg/dl and an increase of cTnT with respect to only 2 patients (1.7%) with increased of NT-proBNP but without cTnT elevation (pConclusions cTnT and NT-proBNP should be routinely evaluated in all SSc patients, even if asymptomatic, in order to identify at early stages those with a subclinical heart disease and a bad cardiac outcome. Patients with cTnT>0.019 ng/ml and NT-proBNP >618 pg/ml have an high risk of cardiac death and need to be strictly monitored. Disclosure of Interest None declared
Joel Neugarten (Fri,) studied this question.