High sensitivity cardiac troponin T levels tied to swollen joints and disease activity in RA patients

IA patients suffer a substantial risk of developing coronary heart disease (CHD) independently of conventional risk factors. It is already known that hsTnT is used as a heart disease marker; it is a marker of myocyte necrosis and injury. Previous studies have shown its potential role in inflammation in other body parts, like the joints.

HsTnT is increased in IA patients. The mechanisms remain unclear, but accumulation suggests inflammation and rupture of atherosclerotic plaques.

Considering the background mentioned above, researchers hypothesized that “hsTnT levels correlate with systemic inflammatory and clinical markers for Inflammatory Arthritis disease activity and may be influenced by antirheumatic therapy.”

The researchers assessed 115 patients with active IA before and after using methotrexate (MTX) alone or tumour necrosis factor inhibitor (TNFi) with or without MTX co-medication (TNFi±MTX). The clinical and laboratory parameters were evaluated at baseline and after six weeks and six months of treatment.

Results:

· 64 patients had rheumatoid arthritis (RA), 31 psoriatic arthritis and 20 ankylosing spondylitis.

· Considering disease activity markers, baseline hsTnT levels positively correlated with Physicians’ Global Assessment Score of disease activity in the total patient cohort.

· In the RA group, there was a positive correlation of hsTnT with swollen joints, Disease Activity Score for 28 joints with ESR and serum tumour necrosis factor levels.

· At baseline, the median hsTnT was 5.0 ng/L, and did not change significantly at 6-week visit and 6-month visit with the value of 6.0 ng/L with either antirheumatic therapy.

Thao H. P. Nguyen from Lillehammer Hospital for Rheumatic Diseases said that when high-risk patients are identified early, it may facilitate precision medicine as an intervention for inflammatory arthritis comorbidity.

Concluding further, there was a correlation between HsTnT levels and inflammatory markers for IA disease activity. Following antirheumatic treatment, there were changes in the inflammatory markers, but hsTnT did not change during the 6-month follow-up period.

Further reading:

Nguyen THP, Fagerland MW, Hollan I, Whist JE, Feinberg MW, Agewall S. 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.