Alopecia Areata is Associated with Increased Expression of Heart Disease Biomarker Cardiac Troponin I

Abstract

The development of androgenetic alopecia is associated with a risk of developing cardiovascular diseases, but the association of alopecia areata with cardiovascular diseases in humans is largely unexplored. We measured the plasma level of two common cardiovascular disease markers, cardiac troponin I and C-reactive protein, in alopecia areata and androgenetic alopecia affected subjects. Also, we investigated the possible presence of pro-apoptotic factors in the plasma of hair loss subjects. The mean plasma cardiac troponin I level was highest in alopecia areata subjects, moderately higher in androgenetic alopecia subjects, and lowest in subjects without hair loss (p <0.05). Alopecia areata subjects not receiving treatments had highest levels of cTnI (p <0.05). Alopecia areata plasma samples with high cardiac troponin I levels also induced significantly higher rates of cardiomyocyte apoptosis in cell culture assays. The results suggest the potential for increased heart remodelling. Close monitoring of cardiovascular health in alopecia areata subjects, as well as subsets of androgenetic alopecia patients, may be appropriate.

Assessment of metabolic profile and ischemia-modified albumin level in patients with alopecia areata: A case–control study

“…demonstrated increased expression of cardiac biomarker troponin in AA patients in a recent report. [28] In a recent study, hypertension and diabetes were more common in late-onset alopecia. [29] Sd-LDL is known to have atherogenic potential.…”

Electrocardiogram Findings in Patients with Alopecia Areata

“…Primary sinus node dysfunction is often caused by fibrosis, and, interestingly, cardiac remodeling and fibrosis have been found in murine models of AA, although conduction system or sinus node disease has not specifically been reported in these models [5,6]. Higher levels of cardiac troponin I have been documented in patients with AA [1], and, in a murine model, an autoimmune response to cardiac troponin I induces cardiac inflammation and fibrosis [7,8]. It is also possible that genes involved in development of sinus node fibrosis overlap with those that determine AA [9,10].…”

“…Comorbid cardiovascular disease in patients with autoimmune disorders is an area of active investigation. In AA patients, higher levels of cardiac troponin I have been documented [1]. One recent study suggests AA patients are at an increased risk of acute myocardial infarction [2], while another study found elevated inflammatory and cardiovascular/atherosclerosis-related biomarkers in AA patients [3].…”

Alopecia areata is not a risk factor for heart diseases: A 10-year retrospective cohort study

“…C3H/HeJ mice with AA had higher levels of cardiac troponin, a serum HD marker, and showed a higher risk of cardiac hypertrophy [13]. In addition, AA patients had increased HD biomarker cardiac troponin I in a previous report [14]. However, no differences were observed in cardiovascular risk between AA patients and controls in a previous cohort study [8].…”

“…In this context, we sought to clarify whether AA patients have a higher risk of cardiac diseases such as ischemic heart disease and heart failure. Some studies claim that AA patients are vulnerable to cardiovascular diseases [ 13 , 14 ]. As AA patients showed increased cardiac marker, we postulated that T cells affecting hair bulbs might extend to other systems.…”