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Associations between anti-mitochondrial antibodies and cardiac involvement in idiopathic inflammatory myopathy patients

A systematic review and meta-analysis

Zusammenhang zwischen antimitochondrialen Antikörpern und kardialer Beteiligung bei Patienten mit idiopathischer inflammatorischer Myopathie

Systematischer Überblick und Metaanalyse

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Abstract

Objective

The objectives of this study are to analyze the association between anti-mitochondrial antibody (AMA) and cardiac involvement in idiopathic inflammatory myopathy (IIM) and to evaluate the diagnostic value of AMA for cardiac involvement in IIM patients.

Methods

We conducted a comprehensive search in PubMed, Web of Science, EMBASE, and the Cochrane Library to identify English-language studies published before November 19, 2021. Stata 12.0 software (Stata Corp., College Station, TX, USA) was used for the statistical analyses. We used the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and summary receiver operating characteristic (SROC) curve to evaluate the diagnostic value of AMA for cardiac involvement in IIM patients. Statistical heterogeneity of studies was assessed using the I2 statistic with 95% confidence intervals (95% CIs).

Results

Seven studies were included in the final analyses, with a total of 2308 IIM patients (including 171 AMA-positive and 2137 AMA-negative patients). The pooled sensitivity of AMA for cardiac involvement in IIM patients was 0.29 (95% CI: 0.19–0.43) and specificity was 0.92 (95% CI: 0.88–0.96). The pooled PLR was 3.9 (95% CI: 2.82–5.38), NLR was 0.76 (95% CI: 0.66–0.88), and the diagnostic odds ratio (DOR) was 5 (95% CI: 3–7). The area under the SROC curve was 0.76 (95% CI: 0.72–0.79).

Conclusion

The overall diagnostic value of AMA may not be very high for cardiac involvement in IIM patients.

Zusammenfassung

Ziel

Ziel der vorliegenden Studie war es, den Zusammenhang zwischen antimitochondrialen Antikörpern (AMA) und Herzbeteiligung bei idiopathischer inflammatorischer Myopathie (IIM) zu untersuchen und die diagnostische Aussagekraft der AMA für eine Herzbeteiligung bei Patienten mit IIM zu ermitteln.

Methoden

Eine umfassende Suche in den Datenbanken PubMed, Web of Science, EMBASE und Cochrane Library wurde durchgeführt, um englischsprachige Studien zu ermitteln, die vor dem 19. November 2021 publiziert worden waren. Für die statistische Auswertung wurde die Software Stata 12.0 benutzt. Zur Bestimmung der diagnostischen Aussagekraft der AMA für eine kardiale Beteiligung bei IIM-Patienten verwendeten die Autoren die Sensitivität, Spezifität, positive Likelihood-Ratio (PLR), negative Likelihood-Ratio (NLR) und Summary-Receiver-Operating-Characteristic(SROC)-Kurve. Die statistische Heterogenität der Studien wurde unter Verwendung der I2-Statistik mit 95 %-Konfidenzintervallen (95 %-KI) ermittelt.

Ergebnisse

In die endgültige Analyse wurden 7 Studien mit 2308 IIM-Patienten (inklusive 171 AMA-positiver und 2137 AMA-negativer Patienten) eingeschlossen. Die gepoolte Sensitivität der AMA für eine kardiale Beteiligung bei IIM-Patienten betrug 0,29 (95 %-KI: 0,19–0,43) und die Spezifität 0,92 (95 %-KI: 0,88–0,96). Die gepoolte PLR lag bei 3,9 (95 %-KI: 2,82–5,38), die NLR bei 0,76 (95 %-KI: 0,66–0,88) und die diagnostische Odds Ratio (DOR) bei 5 (95 %-KI: 3–7). Die Fläche unter der SROC-Kurve betrug 0,76 (95 %-KI: 0,72–0,79).

Schlussfolgerung

Der diagnostische Gesamtwert der AMA für die Herzbeteiligung bei Patienten mit IIM ist möglicherweise nicht besonders hoch.

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Authors and Affiliations

  1. Department of Hangzhou Third People’s Hospital, Zhejiang Chinese Medical University, Hangzhou, China

    Hui Wang, Yuan Zhu, Jieni Jin, Jun Lu & Cong Shen

  2. Department of Hangzhou Third People’s Hospital, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, 310009, Hangzhou, Zhejiang, China

    Jingjing Hu & Zhaobin Cai M.D.

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Correspondence to Zhaobin Cai M.D..

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Conflict of interest

H. Wang, Y. Zhu, J. Hu, J. Jin, J. Lu, C. Shen, and Z. Cai declare that they have no competing interests.

For this article no studies with human participants or animals were performed by any of the authors. All studies mentioned were in accordance with the ethical standards indicated in each case.

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Wang, H., Zhu, Y., Hu, J. et al. Associations between anti-mitochondrial antibodies and cardiac involvement in idiopathic inflammatory myopathy patients. Z Rheumatol 83 (Suppl 1), 214–221 (2024). https://doi.org/10.1007/s00393-022-01216-2

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