Yinghong Tang, Dongyu Li, Wangyan Liu, Yue Zhang, Jiayi Dai, Wei Qian, Linwei Shan, Lin Li, Qi Hu, Changjing Feng, Yinsu Zhu, Xiaoxuan Sun, Li Ma, Qiang Wang, Lei Zhou
{"title":"采用血清cTnT/CK联合抗ro52抗体筛查特发性炎性肌病的心肌累及及预后评估。","authors":"Yinghong Tang, Dongyu Li, Wangyan Liu, Yue Zhang, Jiayi Dai, Wei Qian, Linwei Shan, Lin Li, Qi Hu, Changjing Feng, Yinsu Zhu, Xiaoxuan Sun, Li Ma, Qiang Wang, Lei Zhou","doi":"10.1093/mr/roaf076","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Myocardial involvement in idiopathic inflammatory myopathy (IIM) indicates poor prognosis. This study aimed to identify risk factors for myocardial involvement and assess their prognostic value.</p><p><strong>Methods: </strong>We analysed 92 IIM patients with abnormal cardiac troponin T (cTnT). Myocardial involvement was diagnosed by late gadolinium enhancement on cardiovascular magnetic resonance. All-cause mortality was recorded during follow-up.</p><p><strong>Results: </strong>Among 92 patients, myocardial involvement was observed in 68.5%, who showed increased cTnT/CK ratios and anti-Ro52 antibody positivity rates. Anti-Ro52 positive patients exhibited higher rates of LGE and increased E/e'. Both cTnT/CK (OR = 1.030, p = 0.024) and anti-Ro52 (OR = 5.629, p = 0.003) independently predicted myocardial involvement. A cTnT/CK cut-off > 19.3% predicted myocardial involvement (AUC = 0.660), rising to 0.780 when combined with anti-Ro52. Subgroup analysis showed cTnT/CK was discriminative only in anti-Ro52 negative individuals. During a 36-month follow-up, 18 deaths occurred. Adjusted Cox regression identified cTnI positivity (HR = 7.395, p = 0.001) and cTnT/CK (HR = 1.012, p = 0.037) as independent mortality predictors. Time-dependent ROC at 3 years showed AUCs of 0.68 (cTnI) and 0.64 (cTnT/CK). Kaplan-Meier analysis confirmed worse survival with positive cTnI or high cTnT/CK.</p><p><strong>Conclusion: </strong>The cTnT/CK ratio identifies myocardial involvement and predicts mortality in IIM patients with abnormal cardiac troponin T. Combining it with anti-Ro52 antibodies improves detection of myocardial involvement.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Using serum cTnT/CK combined with anti-Ro52 antibodies to screen for myocardial involvement and assess prognosis in idiopathic inflammatory myopathy.\",\"authors\":\"Yinghong Tang, Dongyu Li, Wangyan Liu, Yue Zhang, Jiayi Dai, Wei Qian, Linwei Shan, Lin Li, Qi Hu, Changjing Feng, Yinsu Zhu, Xiaoxuan Sun, Li Ma, Qiang Wang, Lei Zhou\",\"doi\":\"10.1093/mr/roaf076\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Myocardial involvement in idiopathic inflammatory myopathy (IIM) indicates poor prognosis. This study aimed to identify risk factors for myocardial involvement and assess their prognostic value.</p><p><strong>Methods: </strong>We analysed 92 IIM patients with abnormal cardiac troponin T (cTnT). Myocardial involvement was diagnosed by late gadolinium enhancement on cardiovascular magnetic resonance. All-cause mortality was recorded during follow-up.</p><p><strong>Results: </strong>Among 92 patients, myocardial involvement was observed in 68.5%, who showed increased cTnT/CK ratios and anti-Ro52 antibody positivity rates. Anti-Ro52 positive patients exhibited higher rates of LGE and increased E/e'. Both cTnT/CK (OR = 1.030, p = 0.024) and anti-Ro52 (OR = 5.629, p = 0.003) independently predicted myocardial involvement. A cTnT/CK cut-off > 19.3% predicted myocardial involvement (AUC = 0.660), rising to 0.780 when combined with anti-Ro52. Subgroup analysis showed cTnT/CK was discriminative only in anti-Ro52 negative individuals. During a 36-month follow-up, 18 deaths occurred. Adjusted Cox regression identified cTnI positivity (HR = 7.395, p = 0.001) and cTnT/CK (HR = 1.012, p = 0.037) as independent mortality predictors. Time-dependent ROC at 3 years showed AUCs of 0.68 (cTnI) and 0.64 (cTnT/CK). Kaplan-Meier analysis confirmed worse survival with positive cTnI or high cTnT/CK.</p><p><strong>Conclusion: </strong>The cTnT/CK ratio identifies myocardial involvement and predicts mortality in IIM patients with abnormal cardiac troponin T. Combining it with anti-Ro52 antibodies improves detection of myocardial involvement.</p>\",\"PeriodicalId\":18705,\"journal\":{\"name\":\"Modern Rheumatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2025-08-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Modern Rheumatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1093/mr/roaf076\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"RHEUMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Modern Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/mr/roaf076","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的：特发性炎性肌病（IIM）累及心肌提示预后不良。本研究旨在确定心肌受累的危险因素并评估其预后价值。方法：对92例心肌肌钙蛋白T （cTnT）异常的IIM患者进行分析。心肌受累通过心血管磁共振晚期钆增强诊断。随访期间记录全因死亡率。结果：92例患者中心肌受累率为68.5%，cTnT/CK比值升高，抗ro52抗体阳性率升高。抗ro52阳性患者LGE发生率较高，E/ E′值升高。cTnT/CK （OR = 1.030, p = 0.024）和anti-Ro52 （OR = 5.629, p = 0.003）均独立预测心肌受累。cTnT/CK临界值bb0 19.3%预测心肌受损伤（AUC = 0.660），联合抗ro52时上升至0.780。亚组分析显示cTnT/CK仅在抗ro52阴性个体中具有区别性。在36个月的随访期间，发生了18例死亡。校正Cox回归发现cTnI阳性（HR = 7.395, p = 0.001）和cTnT/CK （HR = 1.012, p = 0.037）是独立的死亡率预测因子。3年的时间相关ROC显示auc为0.68 （cTnI）和0.64 （cTnT/CK）。Kaplan-Meier分析证实cTnI阳性或cTnT/CK高的患者生存率较差。结论：cTnT/CK比值可识别心肌肌钙蛋白t异常的IIM患者心肌受累并预测死亡率，与抗ro52抗体联合可提高心肌受累的检出率。
Using serum cTnT/CK combined with anti-Ro52 antibodies to screen for myocardial involvement and assess prognosis in idiopathic inflammatory myopathy.
Objective: Myocardial involvement in idiopathic inflammatory myopathy (IIM) indicates poor prognosis. This study aimed to identify risk factors for myocardial involvement and assess their prognostic value.
Methods: We analysed 92 IIM patients with abnormal cardiac troponin T (cTnT). Myocardial involvement was diagnosed by late gadolinium enhancement on cardiovascular magnetic resonance. All-cause mortality was recorded during follow-up.
Results: Among 92 patients, myocardial involvement was observed in 68.5%, who showed increased cTnT/CK ratios and anti-Ro52 antibody positivity rates. Anti-Ro52 positive patients exhibited higher rates of LGE and increased E/e'. Both cTnT/CK (OR = 1.030, p = 0.024) and anti-Ro52 (OR = 5.629, p = 0.003) independently predicted myocardial involvement. A cTnT/CK cut-off > 19.3% predicted myocardial involvement (AUC = 0.660), rising to 0.780 when combined with anti-Ro52. Subgroup analysis showed cTnT/CK was discriminative only in anti-Ro52 negative individuals. During a 36-month follow-up, 18 deaths occurred. Adjusted Cox regression identified cTnI positivity (HR = 7.395, p = 0.001) and cTnT/CK (HR = 1.012, p = 0.037) as independent mortality predictors. Time-dependent ROC at 3 years showed AUCs of 0.68 (cTnI) and 0.64 (cTnT/CK). Kaplan-Meier analysis confirmed worse survival with positive cTnI or high cTnT/CK.
Conclusion: The cTnT/CK ratio identifies myocardial involvement and predicts mortality in IIM patients with abnormal cardiac troponin T. Combining it with anti-Ro52 antibodies improves detection of myocardial involvement.
期刊介绍：
Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery.
Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered.
Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
