Troponin elevation independently associates with mortality in systemic sclerosis.
Troponin elevation independently associates with mortality in systemic sclerosis.
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DOI：
10.55563/clinexprheumatol/fytfmy
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发表时间：
2022-10
影响因子：
3.7
通讯作者：
Hummers, L. K.
中科院分区：
文献类型：
--
作者：
Paik, J. J.;Choi, D. Y.;Mukherjee, M.;Hsu, S.;Wigley, F.;Shah, A. A.;Hummers, L. K.
心脏受累在系统性硬化症（SSc）中很常见，肌钙蛋白升高可能是持续心肌疾病的唯一迹象。目的是确定肌钙蛋白升高是否与独特的SSc特征和不良预后相关。这项回顾性的横断面研究纳入了约翰霍普金斯硬皮病中心研究登记的在过去10年中任何肌钙蛋白测量的患者。比较了肌钙蛋白升高组和正常组的临床数据。生存分析包括Cox比例风险和回归分析。272例患者进行了肌钙蛋白检测。83例（31%）肌钙蛋白升高。与肌钙蛋白水平正常的患者相比，肌钙蛋白水平升高的患者更容易出现弥漫性SSc (p=0.005)，左心室射血分数（57.7±20%比64.4±17.4%,p=0.007），预测的强制肺活量（61.1±18.8%比66.8±20.4%,p=0.03），右心室收缩压（51.4±20.9比43.4±15.9 mmHg, p=0.001）， Medsger肌和心脏严重程度评分（p≤0.001）。死亡率更高（28% vs. 9.5%, p≤0.0001）。即使在调整了年龄、性别、病程和心肺危险因素后，肌钙蛋白升高的患者的死亡风险也比肌钙蛋白未升高的患者高2.16倍（95% CI 1.01-4.63, p=0.046）。肌钙蛋白可能是一种有用的预后生物标志物，可以识别出一部分心脏病患者，这可能需要更深入的临床研究。
Cardiac involvement is common in systemic sclerosis (SSc), and elevated troponin may be the only sign of ongoing myocardial disease. The objective was to determine whether the presence of elevated troponin associates with unique SSc characteristics and poor outcomes. This retrospective, cross-sectional study included patients in the Johns Hopkins Scleroderma Center Research Registry with any troponin measurement in the past 10 years. Clinical data were compared between those with elevated versus normal troponin. Survival analyses including Cox proportional hazards and regression analyses were performed. 272 patients with a troponin measurement were identified. 83 (31%) had elevated troponin. Compared to those with a normal troponin level, those with elevated troponin level were more likely to have the diffuse SSc subtype (p=0.005), lower left ventricular ejection fraction (57.7 ± 20% vs. 64.4 ± 17.4%, p=0.007), lower forced vital capacity percent predicted (61.1 ± 18.8% vs. 66.8 ± 20.4%, p=0.03), higher right ventricular systolic pressure (51.4 ± 20.9 vs. 43.4 ± 15.9 mmHg, p=0.001), higher Medsger muscle and heart severity scores (p≤0.001), and higher frequency of mortality (28% vs. 9.5%, p≤0.0001). Patients with elevated troponin also have a 2.16-fold (95% CI 1.01–4.63, p=0.046) increased risk of death compared to those without elevated troponin even after adjusting for age, sex, disease duration, and cardiopulmonary risk factors. Troponin may be a useful prognostic biomarker that may identify a subset of patients with heart disease that may warrant closer clinical investigation.
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影响因子：
27.4
作者：
Allanore, Y.;Wahbi, K.;Meune, C.
通讯作者：
Meune, C.
影响因子：
5
作者：
Erlacher, P;Lercher, A;Mair, J
通讯作者：
Mair, J
影响因子：
4.8
作者：
FOLLANSBEE, WP;ZERBE, TR;MEDSGER, TA
通讯作者：
MEDSGER, TA
影响因子：
8
作者：
Bosello, Silvia;De Luca, Giacomo;Ferraccioli, Gianfranco
通讯作者：
Ferraccioli, Gianfranco
影响因子：
37.8
作者：
Thygesen, Kristian;Alpert, Joseph S.;White, Harvey D.
通讯作者：
White, Harvey D.