Rule of Thrombin Generation Assay in Myocarditis

Background: Myocarditis and Myocardial Infarction share a common clinical similarity despite significant differences in etiology and pathogenesis. The first is an inflammatory process and the later involved in intravascular thrombotic process. According to the medical guidelines, it is recommended to use Cardiac MRI or endocardial biopsy for a definite diagnosis, however, these guidelines are not fully implemented due to the high cost and the risk involved. We used Thrombin Generation Assay and a simple blood test to characterize both diseases.

Method: We conducted a prospective cohort study from April 2018 to December 2018. Patients were eligible for the study if initial clinical suspicious was Non-ST elevation Myocardial Infarction or Myocarditis. Patients were recruited prior to anticoagulant treatment. Patients in both groups went through acceptable standard clinical evaluation.

Results: Twenty eight patients were enrolled in 2 groups. 12 patients included in MI group and 16 patients included in Myocarditis group. Patients in MI group were significantly older (64.25±9.67 vs 37.94±19.66, p<0.01, respectively) with higher prevalence of Hyperlipidemia, Diabetes Mellitus and Ischemic Heart disease (p

Conclusion: Myocarditis and Myocardial Infarction have different pattern of Thrombin Generation Thrombogram. Myocarditis had significantly higher plasma level of ETP. This finding requires greater evaluation in order to define a numerical threshold with high sensitivity and specificity, thus avoiding invasive or expensive assessment of Myocarditis.