Polymyositis and raised troponin after mRNA COVID‐19 vaccination

Ciofani, Jonathan; Ward, L; Liulu, X.; Chan, Rcf; Sampedro, S; Soh, Hwei-Choo; March, L.

doi:10.1111/imj.15882

Cited by 4 publications

(2 citation statements)

References 6 publications

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“…However, a recent study reported that elevated cTnI with normal echocardiogram and cardiac MRI evaluation in a patient of polymyositis after mRNA COVID-19 vaccination, which suggested the presence of interfering antibodies as the most likely explanation. Whether the elevated troponin truly reflected myocardial damage or a laboratory phenomenon in the context of generally increased antibodies in IIMs required further investigation [24].…”

Section: Discussionmentioning

confidence: 99%

The use of high-sensitivity cardiac troponin I in assessing cardiac involvement and Disease prognosis in idiopathic inflammatory myopathy

Zhang,

Chi,

Xie

et al. 2023

Adv Rheumatol

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Objectives Cardiac involvement is one of the most serious complications of idiopathic inflammatory myopathy (IIM) that indicates poor prognosis. However, there is a lack of effective biomarkers for the identification of cardiac involvement and the prediction of prognosis in IIM. Here, we aimed to explore the value of different cardiac biomarkers in IIM patients. Methods A total of 142 IIM patients in the Department of Rheumatology and Immunology, Ruijin Hospital from July 2019 to October 2022 were included in this study. The clinical characteristics, laboratory tests, treatments and prognosis were recorded. The disease activity was assessed according to the core set measures. The correlations of the serum cardiac biomarkers levels with disease activity were analyzed by the Spearman correlation test. Risk factors for cardiac involvement were evaluated by multivariate logistic regression analysis. Results Higher high-sensitivity cardiac troponin I (hs-cTnI) levels were associated with cardiac involvement (n = 41) in IIM patients [adjusted OR 7.810 (95% CI: 1.962–31.097); p = 0.004], independent of other serum cardiac biomarkers. The abnormal hs-cTnI had the highest AUC for distinguishing of cardiac involvement in IIM patients (AUC = 0.848, 95% CI: 0.772,0.924; p < 0.001). Besides, we found that high serum levels of hs-cTnI were significantly correlated with disease activity. Moreover, patients with higher serum levels of hs-cTnI tended to suffer from poor prognosis. Conclusions Serum hs-cTnI testing may play a role in screening for cardiac involvement in IIM patients. Abnormal levels of serum hs-cTnI were associated with increased disease activity and poor prognosis.

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Section: Discussionmentioning

confidence: 99%

The use of high-sensitivity cardiac troponin I in assessing cardiac involvement and Disease prognosis in idiopathic inflammatory myopathy

Zhang,

Chi,

Xie

et al. 2023

Adv Rheumatol

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“…However, since cardiac involvement is a marker of poor prognosis leading to irreversible dysfunction or even death, our patient did undergo cardiac MRI which showed normal cardiac function and parameters. Cardiac magnetic resonance unveils silent, acute or chronic myocarditis in PM/DM and is used to monitor treatment efficacy due to its excellent tissue characterisation 11 12…”

Section: Discussionmentioning

confidence: 99%

The rise and fall of troponin in a patient with polymyositis

Javed

Leung

2023

BMJ Case Rep

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Troponins are an excellent sensitive marker for myocardial ischaemic damage. However, there are several non-ischaemic cardiac and non-cardiac reasons for troponin elevation. Many cases of troponin T elevation and some troponin I cases have been reported in the literature due to inflammatory muscle disease. Here, we report a woman in her 50s who initially presents with fatigue and weakness, and is found to have elevated troponin T. The patient was appropriately worked up for cardiac causes with ECG and echocardiogram. She had positive antinuclear antibodies, antineutrophil cytoplasmic antibody and myositis panel. The elevation of troponins was attributed to polymyositis and treated with methotrexate and prednisone with recovery of patient’s symptoms. This article emphasises the struggle of diagnosis in a patient with no reported medical history, having low to moderate risk of silent myocardial infarction.

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Tozinameran

2023

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Polymyositis and raised troponin after mRNA COVID‐19 vaccination

Cited by 4 publications

References 6 publications

The use of high-sensitivity cardiac troponin I in assessing cardiac involvement and Disease prognosis in idiopathic inflammatory myopathy

The use of high-sensitivity cardiac troponin I in assessing cardiac involvement and Disease prognosis in idiopathic inflammatory myopathy

The rise and fall of troponin in a patient with polymyositis

Tozinameran

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