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Research Article
Jiangang Jiang
Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong Uni
Corresponding Author
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
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.
Methods
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.
Results
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.
Conclusion
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.
Keywords
fulminant myocarditis, high-sensitivity troponin I, absolute change, relative change, in-hospital outcome
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This preprint is under consideration at BMC Cardiovascular Disorders. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research Article
Jiangang Jiang
Division of Cardiology, Department of Internal Medicine, and Hubei Key Laboratory of Genetics and Molecular Mechanisms of Cardiological Disorders, Tongji Hospital, Tongji Medical College, Huazhong Uni
Corresponding Author
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 08 Jan, 2021
No community comments so far
Editorial decision: Major revision
On 19 Jan, 2021
Editor assigned
On 06 Jan, 2021
Editor invited
On 06 Jan, 2021
Submission checks complete
On 06 Jan, 2021
First submitted
On 22 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background
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.
Methods
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.
Results
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.
Conclusion
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
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