The absolute and relative change of high-sensitivity cardiac troponin I are associated with in-hospital outcome of patients with fulminant myocarditis
we sought to describe the tendency and extent of high-sensitivity cardiac troponin I (hs-cTnI) changes in patients with fulminant myocarditis (FM) after admission, and to explore the relationship between in-hospital outcome of FM and the value of absolute and relative change of hs-cTnI within 24 h and 48 h after admission.
a total of 83 cases of FM patient admitted to our center from January 1, 2010 to December 31, 2019 were included, 69 patients survived and 14 patients died. The absolute and relative change of hs-cTnI within 24 h and 48 h were described as range distribution. Receiver operating characteristic (ROC) curves and Cox analysis were performed to determine the relationship between in-hospital outcome of FM and hs-cTnI change.
In survive group, 78% patients experienced the decline of hs-cTnI within 24 h, while 36% of death group had the declined tendency of hs-cTnI (P = 0.003). Absolute and relative change of hs-cTnI within 24 h and 48 h were displayed as range distribution. Multivariate analysis revealed that the decline tendency of hs-cTnI change within 24 h, in addition with time from onset to hospital, intravenous immunoglobulin treatment and abnormal of creatinine, were associated with the outcome of FM (for the decline tendency of hs-cTnI within 24 h, OR = 0.10, 95% CI = 0.02–0.68, P = 0.018). ROC curve revealed optimized cutoff values of -0.618 ng/ml for absolute change within 24 h (AUC = 0.800, P < 0.01), -4.389 ng/ml for absolute change within 48 h (Area Under Curve = 0.711, P < 0.01), -28.46% for relative change within 24 h (AUC = 0.810, P < 0.01), -52.23% for relative change within 48 h (AUC = 0.795, P < 0.01). Absolute change and relative change of hs-cTnI within 24 h and 48 h were strong predictors of in-hospital mortality by COX regression analyzed, after the adjustment for gender, time from onset to admission, occurrence of ventricular tachycardia or ventricular fibrillation.
Most survive FM patients experienced the decline of hs-cTnI within 24 h. The absolute and relative change of hs-cTnI within 24 h and 48 h were strong predictors of in-hospital mortality.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5
Posted 08 Jan, 2021
On 19 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 22 Dec, 2020
The absolute and relative change of high-sensitivity cardiac troponin I are associated with in-hospital outcome of patients with fulminant myocarditis
Posted 08 Jan, 2021
On 19 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 06 Jan, 2021
On 22 Dec, 2020
we sought to describe the tendency and extent of high-sensitivity cardiac troponin I (hs-cTnI) changes in patients with fulminant myocarditis (FM) after admission, and to explore the relationship between in-hospital outcome of FM and the value of absolute and relative change of hs-cTnI within 24 h and 48 h after admission.
a total of 83 cases of FM patient admitted to our center from January 1, 2010 to December 31, 2019 were included, 69 patients survived and 14 patients died. The absolute and relative change of hs-cTnI within 24 h and 48 h were described as range distribution. Receiver operating characteristic (ROC) curves and Cox analysis were performed to determine the relationship between in-hospital outcome of FM and hs-cTnI change.
In survive group, 78% patients experienced the decline of hs-cTnI within 24 h, while 36% of death group had the declined tendency of hs-cTnI (P = 0.003). Absolute and relative change of hs-cTnI within 24 h and 48 h were displayed as range distribution. Multivariate analysis revealed that the decline tendency of hs-cTnI change within 24 h, in addition with time from onset to hospital, intravenous immunoglobulin treatment and abnormal of creatinine, were associated with the outcome of FM (for the decline tendency of hs-cTnI within 24 h, OR = 0.10, 95% CI = 0.02–0.68, P = 0.018). ROC curve revealed optimized cutoff values of -0.618 ng/ml for absolute change within 24 h (AUC = 0.800, P < 0.01), -4.389 ng/ml for absolute change within 48 h (Area Under Curve = 0.711, P < 0.01), -28.46% for relative change within 24 h (AUC = 0.810, P < 0.01), -52.23% for relative change within 48 h (AUC = 0.795, P < 0.01). Absolute change and relative change of hs-cTnI within 24 h and 48 h were strong predictors of in-hospital mortality by COX regression analyzed, after the adjustment for gender, time from onset to admission, occurrence of ventricular tachycardia or ventricular fibrillation.
Most survive FM patients experienced the decline of hs-cTnI within 24 h. The absolute and relative change of hs-cTnI within 24 h and 48 h were strong predictors of in-hospital mortality.
Figure 1
Figure 2
Figure 3
Figure 4
Figure 5