生物标志物对免疫检查点抑制剂相关心肌炎患者激素抵抗及预后的预测价值OA

Objective To investigate predictive value of soluble growth stimulation-expressed gene 2 protein(sST2),cardiac troponin T(cTnT),and creatine kinase-myocardial band(CK-MB)for steroid resistance and prognosis in patients with immune checkpoint inhibitor-associated myocarditis(ICIAM).Methods A total of 28 patients with ICIAM were prospectively enrolled from March 2023 to February 2024 at Zhongshan Hospital,Fudan University.All participants were divided into the steroid-resistant ICIAM(srICIAM)group and the non-srICIAM group.Baseline serum levels of sST2,cTnT and CK-MB were detected prior to treatment initiation.ROC curve analysis was applied to evaluate the predictive value of these biomarkers,and Kaplan-Meier survival analysis was performed to explore the relationship between sST2 and all-cause mortality.Results Baseline sST2,cTnT,and CK-MB levels were significantly higher in the srICIAM group(n=15)than in the non-srICIAM group(n=13,P＜0.05).Combination of cTnT and sST2 improved predictive performance for srICIAM(AUC=0.857,sensitivity 0.714,specificity 1.000).After 6 months of follow-up,the high sST2 group had a significantly higher all-cause mortality than the low sST2 group(P=0.016).Conclusions The combination of sST2 and cTnT could effectively predict srICIAM,and elevated sST2 is associated with increased higher all-cause mortality in ICIAM patients,providing a basis for early risk stratification and treatment optimization.