Chen Hongxi, Kong Lingyao, Zhang Ying, Lin Xue, Shi Ziyan, Du Qin, Wang Xiaofei, Lang Yanlin, Cai Linjun, Mou Zichao, Luo Wenqin, Li Shuangjie, Zhou Hongyu
Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China.
J Clin Med. 2022 Nov 30;11(23):7106. doi: 10.3390/jcm11237106.
Objective: To investigate the clinical characteristics and outcome of myocardial injury in patients with myasthenia gravis (MG). Methods: We retrospectively searched medical records to screen hospitalized patients with MG at our hospital. The troponin T (TnT) levels were deemed necessary to be performed based on the patient’s clinical symptoms and were used as biomarkers of myocardial injury. The patients’ demographic and clinical information were collected. Death was the primary outcome. Results: A total of 336 patients with MG measured TnT levels and were included in the final analysis. The male MG patients with elevated TnT levels had a higher prevalence of infection (56.8% vs. 30.0%, p = 0.001) and myasthenic crisis (37.5% vs. 13.3%, p = 0.001) than those with normal TnT levels. Meanwhile, the female MG patients with elevated TnT levels were older (56.0 (16.6) vs. 49.2 (17.2)) years old, p = 0.007] and had a higher prevalence of infection (65.4% vs. 32.1%, p < 0.001), myasthenic crisis (33.6% vs. 17.9%, p = 0.015), and thymoma (38.5% vs. 16.7%, p = 0.001) than those with normal TnT levels. Older age (coef. = 0.004; p = 0.034), infection (coef. = 0.240; p = 0.001), myasthenic crisis (coef. = 0.312; p < 0.001), thymoma (coef. = 0.228; p = 0.001), and ICI therapy (coef. = 1.220; p < 0.001) were independent risk predictors for increasing log TnT levels. Thirty-seven patients died during hospitalization. High log TnT levels (OR = 8.818; p < 0.001), female sex (OR = 0.346; p = 0.023), thymoma (OR = 5.092; p = 0.002), and infection (OR = 14.597; p < 0.001) were independent risk predictors of death. Conclusions: Our study revealed that the surveillance of myocardial injury biomarkers in MG patients might be beneficial.
探讨重症肌无力(MG)患者心肌损伤的临床特征及预后。方法:我们回顾性检索病历,以筛选我院住院的MG患者。根据患者的临床症状,认为有必要检测肌钙蛋白T(TnT)水平,并将其用作心肌损伤的生物标志物。收集患者的人口统计学和临床信息。死亡是主要结局。结果:共有336例MG患者检测了TnT水平并纳入最终分析。TnT水平升高的男性MG患者感染(56.8%对30.0%,p = 0.001)和肌无力危象(37.5%对13.3%,p = 0.001)的患病率高于TnT水平正常的患者。同时,TnT水平升高的女性MG患者年龄更大(56.0(16.6)岁对49.2(17.2)岁,p = 0.007),感染(65.4%对32.1%,p < 0.001)、肌无力危象(33.6%对17.9%,p = 0.015)和胸腺瘤(38.5%对16.7%,p = 0.001)的患病率高于TnT水平正常的患者。年龄较大(系数 = 0.004;p = 0.034)、感染(系数 = 0.240;p = 0.001)、肌无力危象(系数 = 0.312;p < 0.001)、胸腺瘤(系数 = 0.228;p = 0.001)和免疫检查点抑制剂(ICI)治疗(系数 = 1.220;p < 0.001)是log TnT水平升高的独立风险预测因素。37例患者在住院期间死亡。高log TnT水平(OR = 8.818;p < 0.001)、女性(OR = 0.346;p = 0.023)、胸腺瘤(OR = 5.092;p = 0.002)和感染(OR = 14.597;p < 0.001)是死亡的独立风险预测因素。结论:我们的研究表明,监测MG患者的心肌损伤生物标志物可能有益。