Associations Between Biomarkers of Myocardial Injury and Systemic Inflammation and Risk of Incident Ventricular Arrhythmia

IF 8 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

JACC. Clinical electrophysiology Pub Date : 2024-09-01 DOI:10.1016/j.jacep.2024.04.017

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引用次数: 0

Abstract

Background

Cardiac troponins (cTns) and biomarkers of inflammation are elevated in heart failure (HF) and predict cardiovascular risk. Whether these biomarkers associate with risk of ventricular arrhythmias (VAs) is unclear.

Objectives

This study sought to assess whether cTnT, growth differentiation factor 15 (GDF-15), interleukin-6 (IL-6), and C-reactive protein (CRP) concentrations are associated with incident VA.

Methods

In a prospective, observational study of patients treated with implantable cardioverter-defibrillator, cTnT, GDF-15, IL-6, and CRP were measured at baseline and after 1.4 ± 0.5 years and were associated with implantable cardioverter-defibrillator–detected incident VA, HF hospitalizations, and mortality.

Results

This study included 489 patients aged 66 ± 12 years and 83% were men. Median concentrations of cTnT were 15 (Q1-Q3: 9-25) ng/L at inclusion, and higher concentrations were associated with higher age, male sex, diabetes mellitus, coronary artery disease, and HF. During 3.1 ± 0.7 years of follow-up, 137 patients (28%) had ≥1 VA. cTnT concentrations were associated with an increased VA risk (per log-unit, HR: 1.63; 95% CI: 1.31-2.01; P < 0.001), also after adjustment for age, sex, body mass index, coronary artery disease, HF, renal function, and left ventricular ejection fraction (P < 0.001). GDF-15, IL-6, and CRP concentrations were not associated with incident VA, but all (including cTnT) were associated with HF hospitalization and mortality. Changes in cTnT, GDF-15, IL-6, and CRP from baseline to 1.4 years were not associated with subsequent VA.

Conclusions

Higher concentrations of cTnT, GDF-15, IL-6, and CRP associate with HF hospitalization and death, but only cTnT predict incident VA. These findings suggest that myocardial injury rather than inflammation may play a pathophysiological role in VA and sudden cardiac death.

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心肌损伤和全身炎症生物标志物与室性心律失常发病风险之间的关系

背景：心肌肌钙蛋白（cTns）和炎症生物标志物在心力衰竭（HF）时升高，可预测心血管风险。这些生物标志物是否与室性心律失常（VAs）的风险相关尚不清楚：本研究旨在评估 cTnT、生长分化因子 15 (GDF-15)、白细胞介素 6 (IL-6) 和 C 反应蛋白 (CRP) 的浓度是否与室性心律失常的发生有关：在一项针对接受植入式心律转复除颤器治疗的患者的前瞻性观察研究中，在基线和 1.4 ± 0.5 年后测量了 cTnT、GDF-15、IL-6 和 CRP，它们与植入式心律转复除颤器检测到的 VA 事件、高频住院和死亡率相关：该研究共纳入 489 名患者，年龄为 66 ± 12 岁，83% 为男性。纳入时 cTnT 的中位浓度为 15（Q1-Q3：9-25）纳克/升，浓度较高与年龄、男性、糖尿病、冠状动脉疾病和心房颤动有关。在 3.1 ± 0.7 年的随访期间，137 名患者（28%）≥1 次 VA。cTnT 浓度与 VA 风险增加有关（每对数单位，HR：1.63；95% CI：1.31-2.01；P <0.001），同样在调整年龄、性别、体重指数、冠状动脉疾病、HF、肾功能和左心室射血分数（P 结论）后也是如此：较高浓度的 cTnT、GDF-15、IL-6 和 CRP 与心房颤动住院和死亡有关，但只有 cTnT 可预测 VA 事件。这些发现表明，心肌损伤而非炎症可能在 VA 和心脏性猝死中起着病理生理作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JACC. Clinical electrophysiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

10.30

自引率

5.70%

发文量

250

期刊介绍： JACC: Clinical Electrophysiology is one of a family of specialist journals launched by the renowned Journal of the American College of Cardiology (JACC). It encompasses all aspects of the epidemiology, pathogenesis, diagnosis and treatment of cardiac arrhythmias. Submissions of original research and state-of-the-art reviews from cardiology, cardiovascular surgery, neurology, outcomes research, and related fields are encouraged. Experimental and preclinical work that directly relates to diagnostic or therapeutic interventions are also encouraged. In general, case reports will not be considered for publication.