HsTnT Levels Correlate with Markers in Patients with Inflammatory Arthritis

New data suggested that levels of hsTnT in patients with inflammatory arthritis (IA), were positively correlated with disease activity markers such as swollen joints and serum tumor necrosis factor levels.¹

While hsTnT is primarily used as a marker of heart disease, previous studies have suggested that it has potential to be a useful marker of inflammation in other parts of the body, including the joints.

In the study, investigators, led by Thao H. P. Nguyen, Lillehammer Hospital for Rheumatic Diseases, stated that early identification of high-risk patients could potentially facillitate precision medicine as an intervention of inflammatory arthritis comorbidity.

Data Links Cardiac Injury and Inflammatory Activity

The results demonstrated that the correlation was especially strong in patients with rheumatoid arthritis (RA) possibly indicating a link between cardiac injury and inflammatory disease activity in patients with inflammatory arthritis, particularly those with rheumatoid arthritis, according to the study.

However, despite the correlation between hsTnT and disease activity markers, the levels of hsTnT did not change significantly during the 6-month follow-up period, even with antirheumatic therapy.

Investigators noted that while hsTnT levels may reflect disease activity in patients with inflammatory arthritis, they may not be a reliable indicator of response to therapy, or a potential target for therapy alone.

Further research is needed to understand the underlying mechanisms of the relationship between hsTnT levels and inflammatory disease activity in this population and to determine whether hsTnT levels have a clinical significance in predicting cardiovascular risk.

Assessing hsTnT and Rheumatic Disease Activity

Investigators conducted the prospective observational cohort study with an aim to assess the relationship between high-sensitivity cardiac troponin T levels and disease activity markers in patients with active inflammatory arthritis.

The study included 115 patients diagnosed with active inflammatory arthritis, 64 with rheumatoid arthritis, 31 with psoriatic arthritis, and 20 with ankylosing spondylitis.

Patient evaluations were performed at baseline, as well as after 6 weeks, and again after 6 months of treatment. They were either treated with methotrexate (MTX) alone, or tumor necrosis factor inhibitor (TNFi) with or without methotrexate co-medication.

The study utilized a variety of clinical and laboratory parameters, including hsTnT, which was measured in serum by electro-chemiluminescence immunoassay using Roche Elecsys Troponin T-high sensitivity. Investigators evaluated the correlation between hsTnT levels and disease activity markers, including the Physician's Global Assessment Score of disease activity, swollen joints, and serum tumor necrosis factor levels.

Additionally, changes in hsTnT levels after 6 weeks and 6 months of treatment were also assessed.

The disease activity of inflammatory arthritis is typically assessed through a combination of clinical measures, such as the number of swollen and tender joints, as well as laboratory tests, such as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels.

“In contrast to markers for disease activity, and contrary to a previous study, initiation of MTX or MTX combined with an TNFi in RA and PsA patients and TNFi monotherapy in AS patients, did not lead to reduction in circulating levels of hsTnT during 6-month follow-up period,” investigators wrote. “One may expect that reduction of inflammation in patients with IA would result in decreased levels of hsTnT, but a direct effect of antirheumatic therapy on hsTnT could not be ruled out in the present study.”

References:

1. 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. PMID: 36763689; PMCID: PMC9916599.