High-sensitivity cardiac troponin T is associated with disease activity in patients with inflammatory arthritis

Thao H P Nguyen; Morten Wang Fagerland; Ivana Hollan; Jon Elling Whist; Mark W Feinberg; Stefan Agewall

doi:10.1371/journal.pone.0281155

High-sensitivity cardiac troponin T is associated with disease activity in patients with inflammatory arthritis

PLoS One. 2023 Feb 10;18(2):e0281155. doi: 10.1371/journal.pone.0281155. eCollection 2023.

Authors

Thao H P Nguyen^{1

2

3}, Morten Wang Fagerland⁴, Ivana Hollan^{5

6}, Jon Elling Whist⁷, Mark W Feinberg^{8

9}, Stefan Agewall^{2

10}

Affiliations

¹ Lillehammer Hospital for Rheumatic Diseases, Lillehammer, Norway.
² Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
³ Department of Rheumatology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
⁴ Oslo Centre for Biostatistics and Epidemiology, Research Support Services, Oslo University Hospital, Oslo, Norway.
⁵ Beitostølen Health and Sport Centre, Beitostølen, Norway.
⁶ Norwegian University of Science and Technology, Gjøvik, Norway.
⁷ Department of Laboratory medicine, Innlandet Hospital Trust, Lillehammer, Norway.
⁸ Harvard Medical School, Boston, MA, United States of America.
⁹ Division of Cardiology, Brigham and Women´s Hospital, Boston, MA, United States of America.
¹⁰ Department of Cardiology, Oslo University Hospital, Ullevål, Oslo, Norway.

Abstract

Objective: To investigate whether high-sensitivity cardiac troponin T (hsTnT) correlates to markers of disease activity in inflammatory arthritis (IA), and whether antirheumatic treatment influences hsTnT levels.

Methods: We assessed 115 patients with active IA (64 rheumatoid arthritis (RA), 31 psoriatic arthritis and 20 ankylosing spondylitis) before and after using methotrexate (MTX) alone or tumor necrosis factor inhibitor (TNFi) with or without MTX co-medication (TNFi±MTX). All patients starting with TNFi had been previously unsuccessfully treated with MTX monotherapy. HsTnT (measured in serum by electro-chemiluminescence immunoassay (Roche Elecsys® Troponin T- high-sensitivity)), and other clinical and laboratory parameters were evaluated at baseline, and after 6 weeks and 6 months of treatment.

Results: Of markers of disease activity, baseline levels of hsTnT positively correlated with Physicians' Global Assessment Score of disease activity in the total patient cohort (p = 0.039). In RA group, hsTnT positively correlated with swollen joints, Disease Activity Score for 28 joints with ESR and serum tumor necrosis factor levels (p = 0.025, p = 0.008, p = 0.01, respectively). Median hsTnT at baseline was 5.0 ng/L, and did not change significantly at 6-week visit (6.0 ng/L, p = 0.37) and 6-month visit (6.0 ng/L, p = 0.18) with either antirheumatic therapy.

Conclusions: HsTnT levels were associated with inflammatory markers for IA disease activity. However, while inflammatory markers significantly improved after antirheumatic treatment, hsTnT did not change during the 6-month follow-up period.

Copyright: © 2023 Nguyen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Antirheumatic Agents*
Arthritis, Rheumatoid*
Drug Therapy, Combination
Humans
Methotrexate / therapeutic use
Treatment Outcome
Troponin T
Tumor Necrosis Factor Inhibitors / therapeutic use
Tumor Necrosis Factor-alpha

Substances

Troponin T
Antirheumatic Agents
Methotrexate
Tumor Necrosis Factor-alpha
Tumor Necrosis Factor Inhibitors

Grants and funding

The first author´s scholarship is funded by The Norwegian Women´s Public Health Association, Grant H2/2018, URL: https://sanitetskvinnene.no/. Financial support to the hsTnT analyses was kindly provided by Lillehammer Hospital for Rheumatic Diseases, URL: https://www.revmatismesykehuset.no/. The establishment of PSARA biobank was sponsored by Abbott Laboratories Norway - now AbbVie, URL: https://www.abbvie.no/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.