SPC365

Do cardiac biomarkers predict short and long-outcomes in acute myocarditis? Results of a long-term prospective study

Session: Sessão de Posters 11 - Miocardite Aguda
Speaker: Daniel Inácio Cazeiro

Congress: CPC 2024
Topic: F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
Theme: 17. Myocardial Disease
Subtheme: 17.4 Myocardial Disease – Treatment
Session Type: Cartazes
FP Number: ---
Authors: Daniel Inácio Cazeiro; Miguel Nobre Menezes; Ana Beatriz Garcia; Ana Margarida Martins; Catarina Simões de Oliveira; João Silva Marques; Beatriz Silva; Joana Rigueira; Rui Plácido; Dulce Brito; Ana G. Almeida; Fausto J. Pinto

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Introduction:</strong></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff">Biomarkers such as high sensitivity cardiac Troponin and NT-proBNP are standard tools for the diagnosis and prognosis of cardiovascular diseases. Although often employed in the context of acute myocarditis, their role in risk stratification of these patients is not well established. The aim of this study was to evaluate whether cardiac biomarkers correlate with acute myocarditis outcomes.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Methods:&nbsp;</strong></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000">Prospective observational single-center study including patients admitted with acute myocarditis from 2007 to 2022 and followed at a tertiary cardiology center. Clinical, imaging and laboratory data pertaining to hospital admissions was collected. Patients were followed annually for a minimum of five years with annual clinical, treadmill, Holter and transthoracic echocardiogram. After that period, they were given the choice to continue complete follow-up or be discharged. Patients who were discharged received a telephone follow-up during November 2023. Frequency tables were obtained and data analysis was performed with Chi-square test and Cox regression.</span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Results:</strong></span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff">We enrolled 158 patients, with a mean age of 33&plusmn;13 years and 20 patients were female. The mean follow-up time was 6&plusmn;4,3 years. The majority presented with chest pain (94.3%), and 1.9% exhibited signs of acute heart failure. Severe complications, including cardiogenic shock or arrhythmic storm, were observed in only 7 (3.6%) of the patients during admission. Patients had a mean left ventricle ejection fraction (LVEF) of 58&plusmn;7,8% at admission. Twenty two (13,9%) patients presented with a LVEF&le;50%. During index admission, the peak troponin T level was 2006&plusmn;507ng/L, 4th generation troponin I was 15.2&plusmn;6.5ng/L, and NT-proBNP was 933&plusmn;189 pg/mL.</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff">Troponin T or Troponin I levels did not significantly differ between patients who developed severe complications and those who did not, during index admission. During long-term follow-up, there was also no association between peak troponin levels and readmissions due cardiovascular causes and all-cause death at follow-up.&nbsp;</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff">NT-proBNP levels were higher (4306 &plusmn;1617 pg/mL) in patients with severe complications during index admission (p&lt;0,038), but were not associated with cardiovascular readmissions nor all-cause mortality during follow-up.</span></span></span></span></p>

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<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff"><strong>Conclusion</strong></span></span></span></span><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff">:&nbsp;</span></span></span></span></p>

<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Arial,sans-serif"><span style="color:#000000"><span style="background-color:#ffffff">Troponin levels were not associated with prognosis at any disease stage in patients acute myocarditis, it did not correlate with complications. NT-proBNP levels were associated with complications during index admission, but had no prognostic value during follow-up.</span></span></span></span></p>