TY - JOUR T1 - Abnormal Cardiac Biomarkers in Patients with Systemic Lupus Erythematosus and No Prior Heart Disease: The Role of Endomyocardial Biopsy JF - The Journal of Rheumatology JO - J Rheumatol SP - 1421 LP - 1422 DO - 10.3899/jrheum.190078 VL - 46 IS - 10 AU - GIACOMO DE LUCA AU - CORRADO CAMPOCHIARO AU - LORENZO DAGNA Y1 - 2019/10/01 UR - http://www.jrheum.org/content/46/10/1421.abstract N2 - To the Editor:Tselios, et al reported in their recent study that patients with systemic lupus erythematosus (SLE) who receive prolonged antimalarial (AM) treatment are at increased risk for elevated cardiac biomarkers [brain natriuretic peptide (BNP) and high-sensitivity cardiac troponin I (HS-cTnI)], particularly when persistently elevated creatine phosphokinase (CPK) is present1. Among a well-characterized SLE cohort of 179 patients, the authors found that 16 (all without cardiac disease, renal failure, or pulmonary arterial hypertension) presented an increase of at least 1 cardiac biomarker. Prolonged AM use (> 5.6 yrs) was found to be associated with these laboratory abnormalities, regardless of age and SLE disease duration1. Regarding the potential reason underlying these findings, the authors speculated that AM deposition in muscle tissue (expressed with chronic CPK elevation) could not be restricted to skeletal muscles, and the drug could also accumulate within the myocardium. Therefore, they proposed the evaluation of these cardiac biomarkers as a screening tool for patients with SLE receiving AM … Address correspondence to Dr. G. De Luca, Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy. E-mail: deluca.giacomo{at}hsr.it ER -