Work

Using serum cTnT/CK combined with anti-Ro52 antibodies to screen for myocardial involvement and assess prognosis in idiopathic inflammatory myopathy

Year: 2025

Type: article

Abstract: Objectives To identify risk factors for myocardial involvement in idiopathic inflammatory myopathy (IIM) and evaluate 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 Myocardial involvement occurred in 68.5% and was associated with higher cTnT/creatine kinase (CK) ratios and anti-Ro52 positivity. Anti-Ro52-positive patients exhibited higher rates of late gadolinium enhancement and increased E/e′. Both cTnT/CK [odds ratio (OR) = 1.030, P = .024] and anti-Ro52 (OR = 5.629, P = .003) independently predicted myocardial involvement. A cTnT/CK cutoff > 19.3% predicted myocardial involvement [area under the curve (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 [hazard ratio (HR) = 7.395, P = .001] and cTnT/CK (HR = 1.012, P = .037) as independent mortality predictors. Time-dependent receiver operating characteristic at 3 years showed AUCs of 0.68 (cTnI) and 0.64 (cTnT/CK). Kaplan–Meier analysis confirmed worse survival with positive cTnI or a high cTnT/CK. Conclusions The cTnT/CK ratio identifies myocardial involvement and predicts mortality in IIM patients with abnormal cTnT. Combining it with anti-Ro52 antibodies improves the detection of myocardial involvement.

Source: Modern Rheumatology

DOI: 10.1093/mr/roaf076