Do quantitative levels of cardiac troponin I implicate on severity of disease in children, adolescences, and young adults with acute myocarditis and myopericarditis?

Abstract

Objectives: When cardiac muscle damage occurs, cardiac troponins are released to blood and their detection is used as a marker in clinical setting. The prognostic value of the quantitative levels of blood troponin I in cases of myocarditis and myopericarditis is unclear. The aim of this study was to analyse whether troponin quantitative blood levels can be correlated with the course of hospitalisation and prognosis. Methods: Retrospective data was collected from all consecutive patients aged ≤30 hospitalised with a diagnosis of acute myocarditis or acute myopericarditis in our health Care Campus between the years 2010–2016. Results: Ninety-three patients with myocarditis and myopericarditis were identified. Higher peak troponin levels correlated with longer hospitalisation times in the cardiac or paediatric wards (p = 0.03, Pearson correlation: r −0.23), and median troponin level at admission correlated with longer overall hospitalisation (p = 0.026, Pearson correlation: r = 0.23). Patients admitted to ICU, received oral cardiac supportive therapy or that were discharged with cardiac drugs had higher median troponin compared to patients who were not but this was not statistically significant. A small group of patients that needed intravenous cardiac support had significantly lower median peak troponin levels (n = 4, 0.375ng/ml, p = 0.048). Only two patients needed extracorporeal membrane oxygenation support, and one died. The small number of patients precludes statistical analysis. Conclusion: Higher troponin levels correlated significantly with longer hospitalisation, lower troponin values correlated with intravenous cardiac support, while other variables related to the severity of disease could not be significantly related to higher troponin levels.

Myocarditis in children 2024, new themes and continued questions

“…Based on CDC guidance, troponin elevation is an integral part of the diagnosis of myocarditis and may also be used to chart clinical improvement [64]. However, it has remained unclear in children whether troponin values correlate with CMR evidence of myocardial injury or adverse outcomes [65,66 ▪ ]. Recent data, including children and adults with COVID-19 infection and vaccine-associated myocarditis have shown that higher troponin levels on admission correlate with persistence of myocardial injury on CMR [67 ▪ ].…”