{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:23:28Z","timestamp":1761006208627,"version":"build-2065373602"},"reference-count":48,"publisher":"MDPI AG","issue":"20","license":[{"start":{"date-parts":[[2025,10,19]],"date-time":"2025-10-19T00:00:00Z","timestamp":1760832000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJMS"],"abstract":"<jats:p>The treatment of moderate-to-severe ulcerative colitis often requires escalation from 5-ASA therapy to immunosuppressants or biologic agents. However, the effects of azathioprine and anti-TNF therapies on cardiac status and associated biomolecules remain insufficiently studied. In this prospective observational study, we included 84 patients with moderate-to-severe ulcerative colitis, divided into three treatment groups based on the therapy received (azathioprine, infliximab, or adalimumab), along with 25 healthy controls. Levels of proBNP, NT-proBNP, creatine kinase (CK), CK-MB, and high-sensitivity troponin I (hsTnI) were measured at baseline, 6 h after treatment initiation, and after 3 months of therapy. Troponin levels did not significantly change across the three time points in any treatment group. In contrast, levels of proBNP, NT-proBNP, CK, and CK-MB significantly decreased after 3 months in patients treated with biologics, whereas a significant increase was observed in the azathioprine group. Further prospective trials are needed to adequately assess the cardiac safety of these therapies, particularly in patients with preexisting cardiac impairment.<\/jats:p>","DOI":"10.3390\/ijms262010160","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T08:18:54Z","timestamp":1760948334000},"page":"10160","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Heart Under Pressure: Divergent Cardiac Molecules Responses to Azathioprine and Anti-TNF Therapy in Ulcerative Colitis"],"prefix":"10.3390","volume":"26","author":[{"given":"Mirjana","family":"Cvetkovi\u0107","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, University Hospital Medical Center Be\u017eanijska kosa, 11080 Belgrade, 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Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bojan","family":"Milo\u0161evi\u0107","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"},{"name":"Clinic for General Surgery, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6115-612X","authenticated-orcid":false,"given":"Bojan","family":"Stojanovi\u0107","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medical Sciences, University of Kragujevac, 34000 Kragujevac, Serbia"},{"name":"Clinic for General Surgery, University Clinical Center Kragujevac, 34000 Kragujevac, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Radojica","family":"Stoli\u0107","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Faculty of Medical 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