A Machine-Learning Model for the Prognostic Role of C-Reactive Protein in Myocarditis
Aims: The role of inflammation markers in myocarditis is unclear. We assessed the diagnostic and prognostic correlates of C-reactive protein (CRP) at diagnosis in patients with myocarditis. Methods and results: We retrospectively enrolled patients with clinically suspected (CS) or biopsy-proven (BP) myocarditis, with available CRP at diagnosis. Clinical, laboratory and imaging data were collected at diagnosis and at follow-up visits. To evaluate predictors of death/heart transplant (Htx), a machine-learning approach based on random forest for survival data was employed. We included 409 patients (74% males, aged 37 ± 15, median follow-up 2.9 years). Abnormal CRP was reported in 288 patients, mainly with CS myocarditis (p < 0.001), recent viral infection, shorter symptoms duration (p = 0.001), chest pain (p < 0.001), better functional class at diagnosis (p = 0.018) and higher troponin I values (p < 0.001). Death/Htx was reported in 13 patients, of whom 10 had BP myocarditis (overall 10-year survival 94%). Survival rates did not differ according to CRP levels (p = 0.23). The strongest survival predictor was LVEF, followed by anti-nuclear auto-antibodies (ANA) and BP status. Conclusions: Raised CRP at diagnosis identifies patients with CS myocarditis and less severe clinical features, but does not contribute to predicting survival. Main death/Htx predictors are reduced LVEF, BP diagnosis and positive ANA.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:11 |
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Enthalten in: |
Journal of clinical medicine - 11(2022), 23 vom: 29. Nov. |
Sprache: |
Englisch |
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Beteiligte Personen: |
Baritussio, Anna [VerfasserIn] |
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Links: |
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Themen: |
C-reactive protein |
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Anmerkungen: |
Date Revised 08.03.2023 published: Electronic Citation Status PubMed-not-MEDLINE |
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doi: |
10.3390/jcm11237068 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM35010848X |
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520 | |a Aims: The role of inflammation markers in myocarditis is unclear. We assessed the diagnostic and prognostic correlates of C-reactive protein (CRP) at diagnosis in patients with myocarditis. Methods and results: We retrospectively enrolled patients with clinically suspected (CS) or biopsy-proven (BP) myocarditis, with available CRP at diagnosis. Clinical, laboratory and imaging data were collected at diagnosis and at follow-up visits. To evaluate predictors of death/heart transplant (Htx), a machine-learning approach based on random forest for survival data was employed. We included 409 patients (74% males, aged 37 ± 15, median follow-up 2.9 years). Abnormal CRP was reported in 288 patients, mainly with CS myocarditis (p < 0.001), recent viral infection, shorter symptoms duration (p = 0.001), chest pain (p < 0.001), better functional class at diagnosis (p = 0.018) and higher troponin I values (p < 0.001). Death/Htx was reported in 13 patients, of whom 10 had BP myocarditis (overall 10-year survival 94%). Survival rates did not differ according to CRP levels (p = 0.23). The strongest survival predictor was LVEF, followed by anti-nuclear auto-antibodies (ANA) and BP status. Conclusions: Raised CRP at diagnosis identifies patients with CS myocarditis and less severe clinical features, but does not contribute to predicting survival. Main death/Htx predictors are reduced LVEF, BP diagnosis and positive ANA | ||
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700 | 1 | |a Cheng, Chun-Yan |e verfasserin |4 aut | |
700 | 1 | |a Lorenzoni, Giulia |e verfasserin |4 aut | |
700 | 1 | |a Basso, Cristina |e verfasserin |4 aut | |
700 | 1 | |a Rizzo, Stefania |e verfasserin |4 aut | |
700 | 1 | |a De Gaspari, Monica |e verfasserin |4 aut | |
700 | 1 | |a Fachin, Francesco |e verfasserin |4 aut | |
700 | 1 | |a Giordani, Andrea Silvio |e verfasserin |4 aut | |
700 | 1 | |a Ocagli, Honoria |e verfasserin |4 aut | |
700 | 1 | |a Pontara, Elena |e verfasserin |4 aut | |
700 | 1 | |a Cattini, Maria Grazia Peloso |e verfasserin |4 aut | |
700 | 1 | |a Bison, Elisa |e verfasserin |4 aut | |
700 | 1 | |a Gallo, Nicoletta |e verfasserin |4 aut | |
700 | 1 | |a Plebani, Mario |e verfasserin |4 aut | |
700 | 1 | |a Tarantini, Giuseppe |e verfasserin |4 aut | |
700 | 1 | |a Iliceto, Sabino |e verfasserin |4 aut | |
700 | 1 | |a Gregori, Dario |e verfasserin |4 aut | |
700 | 1 | |a Marcolongo, Renzo |e verfasserin |4 aut | |
700 | 1 | |a Caforio, Alida Linda Patrizia |e verfasserin |4 aut | |
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