Prognostic Value of Troponin to Lymphocyte Ratio in Patients with Immune Checkpoint Inhibitor-associated Myocarditis.

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Arquivos brasileiros de cardiologia Pub Date : 2025-07-01 DOI:10.36660/abc.20250047

Wanwen Chen, Wenhao Zhang, Caiyin Luo, Junying Cai, Xinqing Lin, Chengzhi Zhou, Yuwen He

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Abstract

Background: Immune checkpoint inhibitor (ICI)-associated myocarditis is a rare but life-threatening immune-related adverse event (irAE). Cardiac troponin (cTn) and absolute lymphocyte count (ALC) have been reported to be associated with ICI-myocarditis.

Objective: We aimed to investigate the prognostic value of the combination of these two features (cTn/ALC ratio) in ICI-associated myocarditis.

Methods: Our center performed a retrospective analysis of 46 patients with ICI myocarditis (cases) and 46 patients without myocarditis after receiving ICI (controls). We obtained data on cardiac enzymes, routine blood parameters, and other clinical biomarkers. Statistical significance was defined as a two-sided α level of 0.05. The association between these covariates and the clinical outcomes of ICI-mediated myocarditis was also tested.

Results: Abnormally elevated cTn (p < 0.001), cTn/ALC ratio (p < 0.001), and decreased ALC (p < 0.001) were observed in patients who developed ICI-myocarditis. The cTn/ALC ratio was associated with the development of severe myocarditis (OR, 5.05; 95% CI, 1.22-20.84; p = 0.025). Survival analysis and Cox regression analysis indicated that a higher cTn/ALC ratio emerged as a significant independent predictor for major adverse cardiac events (MACE) [HR, 5.64; 95%CI, 1.43-22.34; p = 0.014].

Conclusions: An increase in the cTn/ALC ratio was associated with the severity of ICI-myocarditis and could be an effective predictor of poor prognosis in patients with ICI-associated myocarditis.

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肌钙蛋白与淋巴细胞比值在免疫检查点抑制剂相关性心肌炎患者中的预后价值。

背景：免疫检查点抑制剂（ICI）相关心肌炎是一种罕见但危及生命的免疫相关不良事件（irAE）。心肌肌钙蛋白（cTn）和绝对淋巴细胞计数（ALC）被报道与ici -心肌炎有关。目的：探讨cTn/ALC比值对ici相关性心肌炎预后的影响。方法：本中心回顾性分析46例ICI心肌炎患者（病例）和46例非ICI心肌炎患者（对照）。我们获得了心脏酶、常规血液参数和其他临床生物标志物的数据。统计学显著性定义为双侧α水平为0.05。这些协变量与ici介导的心肌炎的临床结果之间的关联也进行了测试。结果：ci -心肌炎患者cTn异常升高（p < 0.001）， cTn/ALC异常升高（p < 0.001）， ALC异常降低（p < 0.001）。cTn/ALC比值与严重心肌炎的发生相关（OR, 5.05; 95% CI, 1.22-20.84; p = 0.025）。生存分析和Cox回归分析表明，较高的cTn/ALC比值是主要不良心脏事件（MACE）的重要独立预测因子[HR， 5.64；95%置信区间,1.43 - -22.34;P = 0.014]。结论：cTn/ALC比值的升高与ici -心肌炎的严重程度相关，可作为ici -心肌炎患者预后不良的有效预测指标。

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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Arquivos brasileiros de cardiologia

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