Τίτλος:
Stronger correlation with myocardial ischemia of high-sensitivity troponin T than other biomarkers
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Background: Acute myocardial infarction (AMI) is considered a major cause of death and disability. Myocardial perfusion scintigraphy (MPS) as a non-invasive diagnostic imaging procedure and certain biomarkers associated with myocardial ischemia (ISCH), such as ischemia-modified albumin (IMA), neuropeptide Y (NPY), N-terminal pro b-type natriuretic peptide (NT-proBNP), and high-sensitivity troponin T (hsTnT) could probably aid in the detection of myocardial infarction. Methods: Between December 2011 and June 2012, we prospectively analyzed patients who underwent a MPS study with the clinical question of myocardial ISCH. An exercise test was performed along with a MPS. Blood was drawn from the patients before exercise and the within 3 minutes from achieving maximum load and was analyzed for the aforementioned biomarkers. Results: A total of 71 patients (56 men and 15 women) were enrolled with a mean age of 61 ± 12 years. Twenty-six patients (36.6%) showed reduced uptake on stress MPS images that normalized at rest, a finding consistent with ISCH. Between ISCH and non-ISCH groups, only hsTnT levels showed a significant difference with the highest levels pertaining to the former group both before (0.0075 ng/ml vs 0.0050 ng/ml, P = 0.023) and after stress exercise (0.0085 vs 0.0050, P = 0.015). The most prominent differences were seen in higher stages of the Bruce protocol (stress duration > 9.05 minutes – P < 0.017). None of the IMA, NPY, and NP-pro BNP showed significant differences in time between the two groups. Conclusions: Although IMA, NPY, and NT-pro BNP may not detect minor ischemic myocardial insults, serum hsTnT holds a greater ability of detecting not only myocardial infarction but also less severe ischemia. Further studies with larger cohorts of patients are warranted in order to better define the role of hsTnT as a screening tool for myocardial ischemia. © 2018, American Society of Nuclear Cardiology.
Συγγραφείς:
Pipikos, T.
Kapelouzou, A.
Tsilimigras, D.I.
Fostinis, Y.
Pipikou, M.
Theodorakos, A.
Pavlidis, A.N.
Kontogiannis, C.
Cokkinos, D.V.
Koutelou, M.
Περιοδικό:
Journal of Nuclear Cardiology
Εκδότης:
Springer New York LLC
Λέξεις-κλειδιά:
amino terminal pro brain natriuretic peptide; ischemia modified albumin; neuropeptide Y; tetrofosmin tc 99m; troponin T; biological marker; brain natriuretic peptide; human serum albumin; ischemia-modified albumin; neuropeptide Y; peptide fragment; pro-brain natriuretic peptide (1-76); troponin T, adult; area under the curve; Article; controlled study; diagnostic test accuracy study; exercise test; female; heart muscle ischemia; heart muscle perfusion; heart scintiscanning; human; major clinical study; male; middle aged; predictive value; priority journal; prospective study; protein blood level; receiver operating characteristic; sensitivity and specificity; aged; blood; diagnostic imaging; exercise; heart infarction; heart muscle ischemia; probability, Aged; Area Under Curve; Biomarkers; Exercise; Female; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Ischemia; Natriuretic Peptide, Brain; Neuropeptide Y; Peptide Fragments; Probability; Prospective Studies; Sensitivity and Specificity; Serum Albumin, Human; Troponin T
DOI:
10.1007/s12350-018-1199-6
