Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Ivandic, BT; Spanuth, E; Kleber, M; Grammer, TB; Marz, W.
High-sensitivity troponin T improves the prognostic value of N-terminal pro-B-type natriuretic peptide in patients with stable coronary artery disease: results from the LURIC Study.
Clin Chem Lab Med. 2011; 49(6):1053-1058
Doi: 10.1515/CCLM.2011.176
Web of Science
PubMed
FullText
FullText_MUG
- Co-Autor*innen der Med Uni Graz
- März Winfried
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- Abstract:
- Background: Cardiac troponin T is an established prognostic marker in patients with acute coronary syndromes, but not in stable coronary artery disease (CAD) like N-terminal pro-B-type natriuretic peptide (NT-proBNP). We examined the additive prognostic value of a high-sensitivity troponin T (hsTnT) assay to predict adverse clinical outcomes in stable CAD. Methods: A retrospective nested case-control analysis of 256 patients with stable CAD who participated in the LURIC study: 128 cases who died from cardiovascular causes during a median follow-up of 7.5 years and 128 survivors (controls) matched for age and gender, were included. hsTnT and NT-proBNP were determined in baseline samples using immunoassays (Roche Diagnostics, Germany). Results: Sixty-two percent of the 256 subjects exhibited concentrations of hsTnT >= 14 ng/L, the manufacturer recommended cut-off to diagnose myocardial infarction in patients with acute chest pain. hsTnT, NT-proBNP, diabetes mellitus and fasting glucose were associated with cardiovascular mortality in univariate analysis. Logistic regression identified hsTnT and NT-proBNP as independent risk markers. Receiver operator characterisitc (ROC) curves analysis identified optimal cut-offs at 15 ng/L and 352 mu g/L for hsTnT (AUC 0.728, p < 0.05) and NT-proBNP (AUC 0.751, p=0.07), respectively. Patients with one or two positive markers exhibited 5-year cardiovascular mortalities of 40% and 60%, respectively, compared to 10% in patients with negative markers. The addition of hsTnT to NT-proBNP significantly increased c-statistics of proportional hazards calculated from survival times as well as net reclassification indexes. Conclusions: Many patients with stable CAD exhibited increased concentrations of hsTnT. The combined determination of NT-proBNP and hsTnT was superior for risk stratification compared to determining either marker alone.
- Find related publications in this database (using NLM MeSH Indexing)
- Aged -
- Coronary Artery Disease - blood Coronary Artery Disease - diagnosis Coronary Artery Disease - mortality
- Female -
- Humans -
- Male -
- Natriuretic Peptide, Brain - blood
- Peptide Fragments - blood
- Prognosis -
- Retrospective Studies -
- Risk -
- Troponin T - blood
- Find related publications in this database (Keywords)
- myocardial infarction
- natriuretic peptide
- risk factor
- troponin