Simple blood test may predict cardiac sarcoidosis outcomes
Study links high levels of blood protein to increased risk of death, complications
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Elevated levels of a blood protein called high-sensitivity cardiac troponin T (hs-cTnT) are associated with an increased risk of death and other adverse outcomes in people with cardiac sarcoidosis, and using a “simple, widely available blood test” measuring these levels to assess risk “could improve how we assess risk and make treatment plans for patients,” researchers wrote in a review paper.
“This systematic review shows that a high level of hs-cTnT is strongly associated with the worst outcomes in [cardiac sarcoidosis], regardless of other clinical factors,” they wrote.
The paper, “High-Sensitivity Cardiac Troponin as a Predictor of Adverse Events in Cardiac Sarcoidosis: A Systematic Review,” was published in the Cureus Journal of Medical Sciences.
Sarcoidosis is characterized by the formation of abnormal clumps of immune cells, which can affect organs throughout the body. In cardiac sarcoidosis, the heart is affected, which can lead to complications such as irregular heartbeats and reduced heart function, increasing mortality risk.
hs-cTnT is released by heart muscles when they are damaged. Studies have reported that elevated hs-cTnT levels are an independent risk factor for death and serious health problems in people with cardiac sarcoidosis.
Review focuses on 3 studies
The researchers reviewed three studies that examined the utility of hs-cTnT in predicting outcomes in people with cardiac sarcoidosis. The three studies were all conducted in Japan and covered a total of 258 patients with an average age in the early 60s.
The researchers noted that patients with high hs-cTnT tended to be older and were more likely to be male. Those with high levels of this heart damage marker also frequently had elevated levels of other heart damage markers, such as BNP (B-type natriuretic peptide).
All the studies found that patients with elevated hs-cTnT had a significantly elevated risk of a composite outcome that included death as well as hospitalization due to heart failure. After accounting for factors including age and sex, the lowest estimates indicated that patients with high hs-cTnT levels were more than four times as likely to hit this composite outcome, while the highest estimate indicated a more than sevenfold increase in risk. Analyses looking only at the risk of death also generally showed an increased risk among patients with elevated hs-cTnT.
“The three studies included in the systematic review consistently show that hs-cTnT levels are a powerful and independent predictor of adverse events in patients with [cardiac sarcoidosis],” the researchers concluded, adding that the results “demonstrated the potential of hs-cTnT as a non-invasive tool to help detect patients at higher risk of developing cardiac adverse events.”
The researchers found that hs-cTnT levels weren’t consistently associated with heart imaging findings, even though they were associated with the risk of death. The fact that imaging techniques assess disease components such as inflammation and fibrosis (scarring), whereas hs-cTnT is a direct measure of damage to heart muscle cells, could help explain the poor correlation. This “indicates hs-cTnT’s potential as a complementary biomarker, as it offers prognostic information that is not identifiable by imaging alone,” the team said.
Although the review was limited to a few studies from one country, the data suggest that measuring hs-cTnT levels could be an easy way to help guide care for cardiac sarcoidosis patients, the researchers said.
“Incorporating hs-cTnT into risk models may allow the earlier identification of high-risk individuals who could benefit from intensified monitoring, prophylactic device implantation, or escalation of immunosuppressive therapy,” they wrote. “Furthermore, serial hs-cTnT monitoring could provide a dynamic assessment of treatment response.”
