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

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. and Haberland, A. and Bartel, S. and Araujo, R. and Valda, G. and Reynaga, D.D. and Ramirez, I.D. and Borges, A.C. and Wallukat, G. and 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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