Combined measurement of N-terminal pro-B-type natriuretic peptide and highly sensitive cardiac troponin T for diagnosis and monitoring of heart injury in chronic Chagas' disease

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Item Type:	Article
Title:	Combined measurement of N-terminal pro-B-type natriuretic peptide and highly sensitive cardiac troponin T for diagnosis and monitoring of heart injury in chronic Chagas' disease
Creators Name:	Munoz Saravia, S.G., Haberland, A., Bartel, S., Araujo, R., Valda, G., Reynaga, D.D., Ramirez, I.D., Borges, A.C., Wallukat, G., Ziebig, R. and Schimke, I.
Abstract:	OBJECTIVE: Chronic Chagas disease afflicts millions of patients in Latin America of which 70% remain asymptomatic but 30% develop fatal heart injury. To evaluate the impact of laboratory medicine for diagnosis and guiding of patients with Chagas' heart disease, we measured N-terminal B-type natriuretic peptide (NT-proBNP) and cardiac troponin T (cTnT). DESIGN AND METHODS: NT-proBNP and cTnT using the highly sensitive assay (hs-cTnT) were measured in 48 asymptomatic Chagas' patients (control group; (-) CM), and in symptomatic patients who suffered from mild/moderate (group (+/++) CM, n=62) or severe cardiomyopathy (group (+++) CM, n=27). RESULTS: Both markers were higher in CM vs. (-) CM and increased with the cardiomyopathy severity. Values of 3 ng/L cTnT and 160 ng/L NT-proBNP were calculated as optimal cut-offs to distinguish (-) CM vs. CM. The NT-proBNP cut-off of 125 ng/L, as recommended by international guidelines, was additionally incorporated in the analysis. Cardiomyopathy was most successfully predicted by dual positivity of both markers (positive predictive value = 1.0). Negativity of both markers effectively excluded cardiomyopathy (negative predictive value of 0.85). Positivity for at least one of the marker is the best for overall correct classification. CONCLUSIONS: Combined measurement of hs-cTnT and NT-proBNP can be used for diagnosis and monitoring of cardiomyopathy in chronic Chagas' patients. In this way, laboratory medicine increases the pre-test probability of the cardiologic diagnostics, which would reduce its time, cost, and logistical problems.
Keywords:	B-Type Natriuretic Peptides, Cardiac Troponins, Cardiomyopathy, Chagas' Heart Disease, Chronic Chagas' Disease, hs-cTnT, NT-proBNP
Source:	Clinical Biochemistry
ISSN:	0009-9120
Publisher:	Elsevier / Pergamon
Volume:	46
Number:	15
Page Range:	1615-1618
Date:	October 2013
Official Publication:	https://doi.org/10.1016/j.clinbiochem.2013.06.011
PubMed:	View item in PubMed

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