Abstract 17184: Is Acute Myopericarditis a Bening Pericarditic Syndrome?
Acute pericarditis is a clinical syndrome of benign course. Cardiac troponin I has been considered a marker of poor prognostic in this setting. However, data regarding prognostic value of troponin I are lacking.The purpose of this study was to evaluate prognostic value of troponin I in acute myopericarditis (AM).
Methods: From July 2004 to December 2011 were included 103 consecutive patients (pts) with AM. Clinical data, ECG and echocardiographic parameters as well as development of complications during hospitalization [arrhythmias, left ventricular dysfunction (LVD), acute heart failure (AHF), pericardial effusions and mortality] were collected.
Results: Mean age was 33±14 years, 84% were males. Mean follow-up was 72±14 months. Thirty three pts (32%) developed complications: Eighteen pts(17%) developed LVD, 4 pts (3.8%) AHF, 12 pts(11.6%) presented mild pericardial effusions and 17(16.5%) had arrhythmias. Levels of myocardial damage markers and inflammatory parameters were associated with the development of LVD and AHF. The ROC curves were performed to estimate the sensibility and specificity of myocardial damage markers and risk of complications. In the case of LVD, established a cutoff level of Troponin I of 5ng/mL with a sensitivity and specificity of 93% and 76% (p<0.000). In the case of AHF established a cutoff level of troponin I of 15 ng/mL, with a level of sensitivity and specificity of 75% and 92% (p<0.009). The pts with EF ≤50% on initial echocardiography were the only ones who developed AHF. We observed an inverse correlation between LVD and the troponin I level. This relationship was demonstrated with baseline Troponin I (p<0.001), peak troponin I (p<0.001), baseline CK (p=0,006) and peak CK (p<0.001). Clinical parameters independently associated with complications were troponin levels, cardiomegaly and EF≤50%. The presence and percentaje of myocardial mass with late-contrast enhanced CMR were associated with mean elevation of troponin and further deterioration of left ventricular function.
Conclusions: The mean elevation of troponin I is a predictor of complications. Patients with normal left ventricular function y Troponin I levels≤5ng/dL have a good clinical prognosis and can have a close out-patient follow-up.
- © 2012 by American Heart Association, Inc.