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  • Myhre, Peder L.Akershus Univ Hosp, Norway; Univ Oslo, Norway (author)

Cardiac troponin T and NT-proBNP for detecting myocardial ischemia in suspected chronic coronary syndrome

  • Article/chapterEnglish2022

Publisher, publication year, extent ...

  • Elsevier Ireland Ltd,2022
  • electronicrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:liu-187298
  • https://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-187298URI
  • https://doi.org/10.1016/j.ijcard.2022.05.027DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agencies|Akershus University Hospital; Norwegian Research Council; South-Eastern Norway Regional Health Authority; EU (FP7) framework program; SouthEastern Norway Regional Health Authority
  • Background: Elevated N-terminal pro-B-type natriuretic peptides (NT-proBNP) and cardiac troponin T (cTnT) are associated with poor outcome in patients with chronic coronary syndrome (CCS). The performance of these biomarkers in diagnosing ischemia, and their association with myocardial hypoperfusion and hypokinesis is unclear. Methods: Patients with suspected CCS (history of angina, estimated cardiovascular risk >15% or a positive stress test) were included in the prospective, multi-center DOPPLER-CIP study. Patients underwent Single Positron Emission Computed Tomography for assessment of ischemia and NT-proBNP and cTnT were measured in venous blood samples. Results: We included 430 patients (25% female) aged 64 +/- 8 years. Reversible hypoperfusion and hypokinesis were present in 139 (32%) and 89 (21%), respectively. Concentrations of NT-proBNP and cTnT correlated moderately (rho = 0.50, p < 0.001). NT-proBNP and cTnT concentrations (median [IQR]) were higher in patients with versus without reversible ischemia: 150 (73-294) versus 87 (44-192) ng/L and 10 (6-13) versus 7 (4-11) ng/L, respectively (p < 0.001 for both), and the associations persisted after adjusting for possible confounders. The C-statistics to discriminate ischemia ranged from 63%-73%, were comparable for cTnT and NT-proBNP, and higher for hypokinesis than hypoperfusion, and both were superior to exercise electrocardiography and stress echocardiography. Very low concentrations (<= 5 ng/L cTnT and <= 60 ng/L NT-proBNP) ruled out reversible hypokinesis with negative predictive value >90%. Conclusion: cTnT and NT-proBNP are associated with irreversible and reversible ischemia in patients with suspected CCS, particularly hypokinesis. The diagnostic performance was comparable between the biomarkers, and very low concentrations may reliably rule out ischemia.

Subject headings and genre

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  • Rosjo, HelgeUniv Oslo, Norway; Akershus Univ Hosp, Norway (author)
  • Sarvari, Sebastian IUniv Oslo, Norway; Oslo Univ Hosp, Norway (author)
  • Ukkonen, HeikkiTurku Univ Hosp, Finland (author)
  • Rademakers, FrankUniv Hosp Leuven, Belgium (author)
  • Engvall, JanLinköpings universitet,Avdelningen för diagnostik och specialistmedicin,Medicinska fakulteten,Centrum för medicinsk bildvetenskap och visualisering, CMIV,Region Östergötland, Fysiologiska kliniken US(Swepub:liu)janen74 (author)
  • Hagve, Tor-ArneUniv Oslo, Norway (author)
  • Nagel, EikeKings Coll Hosp London, England (author)
  • Sicari, RosaCNR, Italy (author)
  • Zamorano, Jose L.Hosp Univ Ramon y Cajal, Spain (author)
  • Monaghan, MarkKings Coll Hosp London, England (author)
  • Dhooge, JanUniv Hosp Leuven, Belgium (author)
  • Edvardsen, ThorUniv Oslo, Norway; Oslo Univ Hosp, Norway (author)
  • Omland, TorbjornAkershus Univ Hosp, Norway; Univ Oslo, Norway (author)
  • Akershus Univ Hosp, Norway; Univ Oslo, NorwayUniv Oslo, Norway; Akershus Univ Hosp, Norway (creator_code:org_t)

Related titles

  • In:International Journal of Cardiology: Elsevier Ireland Ltd361, s. 14-170167-52731874-1754

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