Pentraxin-3 vs C-reactive protein and other prognostic biomarkers in acute coronary syndrome: A substudy of the Platelet Inhibition and Patients Outcomes (PLATO) trial

Aims: We investigated the dynamics, associations with patient characteristics, other biomarkers, and clinical outcomes of pentraxin 3 in acute coronary syndrome. Methods and results: In multivariate analyses, pentraxin 3 measured in 5154 patients randomised in the Platelet Inhibition and Patients Outcomes (PLATO) trial (NCT00391872) was compared with leukocytes, high-sensitivity C-reactive protein, interleukin-6, cystatin C, N-terminal prohormone brain natriuretic peptide, high-sensitivity troponin T and growth differentiation factor 15 concerning prediction of clinical outcome. Pentraxin 3 peaked earlier than high-sensitivity C-reactive protein and was more strongly correlated with N-terminal prohormone brain natriuretic peptide and high-sensitivity troponin T than with high-sensitivity C-reactive protein. The frequency of cardiovascular death, spontaneous myocardial infarction or stroke by quartiles of pentraxin 3 at admission was 6.1%, 7.3%, 9.7% and 10.7%, respectively ( p<0.0001). The hazard ratio per 50% increase of pentraxin 3 was 1.13 (95% confidence interval: 1.07–1.19), p<0.0001. This association remained significant after stepwise adjustments for leukocytes/high-sensitivity C-reactive protein (1.09 (1.02–1.15)), p=0.009, interleukin-6 (1.07 (1.01–1.14)), p=0.026, and cystatin C (1.07 (1.00–1.13)), p=0.044, but not after adjustment for N-terminal prohormone brain natriuretic peptide, high-sensitivity troponin T and growth differentiation factor 15. Admission pentraxin 3 was also associated with several of the individual endpoint components (cardiovascular death/spontaneous myocardial infarction; p=0.008, cardiovascular death; p=0.026, and spontaneous myocardial infarction; p=0.017), but not with stroke. Pentraxin 3 measured in the chronic phase (i.e. at one month) was still predictive of the composite endpoint in univariate analysis (1.12 (1.04–1.20) per 50% increase) p=0.0024, but not after adjustment for the other biomarkers. Conclusion: Admission level of pentraxin 3 is a modestly stronger predictor than high-sensitivity C-reactive protein and interleukin-6, but not than N-terminal prohormone brain natriuretic peptide or high-sensitivity troponin T, concerning cardiovascular outcome in acute coronary syndrome. Pentraxin 3 is more strongly correlated with N-terminal prohormone brain natriuretic peptide and high-sensitivity troponin T than with high-sensitivity C-reactive protein.

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Prognostic Value of N-Terminal Pro-Brain Natriuretic Peptide and High-Sensitivity Troponin T Levels in the Natural History of Transthyretin Amyloid Cardiomyopathy and Their Evolution after Tafamidis Treatment

Journal of Clinical Medicine ◽

10.3390/jcm10214868 ◽

2021 ◽

Vol 10 (21) ◽

pp. 4868

Author(s):

Silvia Oghina ◽

Constant Josse ◽

Mélanie Bézard ◽

Mounira Kharoubi ◽

Marc-Antoine Delbarre ◽

...

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Prognostic Value ◽

Troponin T ◽

High Sensitivity ◽

Relative Increase ◽

High Sensitivity Troponin ◽

Increased Risk ◽

Amyloid Cardiomyopathy ◽

High Sensitivity Troponin T

Background: We assesse the evolution and prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity troponin T (cTnT-HS) in transthyretin amyloid cardiomyopathy (ATTR-CA) before and after tafamidis treatment. Methods and Results: 454 ATTR-CA patients without tafamidis (Cohort A) and 248 ATTR-CA with tafamidis (Cohort B) were enrolled. Event-free survival (EFS) events were death, heart transplant, or acute heart failure. In Cohort A, 27% of patients maintained NT-proBNP < 3000 ng/L and 14% cTnT-HS < 50 ng/L at 12 months relative to baseline levels. In Cohort B, the proportions were 49% and 29%, respectively. In Cohort A, among the 333 patients without an increased NT-proBNP > 50% relative to baseline EFS was extended compared to the 121 patients with an increased NT-proBNP > 50% (HR: 0.75 [0.57; 0.98]; p = 0.032). In Cohort A, baseline NT-proBNP > 3000 ng/L and cTnT-HS > 50 ng/L and a relative increase of NT-proBNP > 50% during follow-up were independent prognostic factors of EFS. The slopes of logs NT-proBNP and cTnT-HS increased with time before and stabilized after tafamidis. Conclusion: ATTR-CA patients with increasing NT-proBNP had an increased risk of EFS. Tafamidis stabilize NT-proBNP and cTnT-HS increasing, even if initial NT-proBNP levels were >3000 ng/L. Thus suggesting that all patients, irrespective of baseline NT-proBNP levels, may benefit from tafamidis.

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P43 N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE BUT NOT HIGH-SENSITIVITY C-REACTIVE PROTEIN IS RELATED TO SEVERITY OF CORONARY STENOSIS IN ACUTE CORONARY SYNDROME

Atherosclerosis Supplements ◽

10.1016/s1567-5688(10)70110-0 ◽

2010 ◽

Vol 11 (2) ◽

pp. 25-26

Author(s):

S. Li ◽

Z. Sun ◽

J. Wang ◽

T. Yang

Keyword(s):

Acute Coronary Syndrome ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Coronary Stenosis ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome

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Borderline Values of Troponin-T and High Sensitivity C-Reactive Protein Did Not Predict 2-Year Mortality in TnT Positive Chest-Pain Patients, Whereas Brain Natriuretic Peptide Did

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2015.00016 ◽

2015 ◽

Vol 2 ◽

Author(s):

Dennis W. T. Nilsen ◽

Øistein Rønneberg Mjelva ◽

Ricardo A. Leon de la Fuente ◽

Patrycja Naesgaard ◽

Volker Pönitz ◽

...

Keyword(s):

Chest Pain ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Troponin T ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Pain Patients

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The role and efficacy of routine high-sensitivity troponin T screening in paediatric COVID-19

Cardiology in the Young ◽

10.1017/s1047951121005199 ◽

2022 ◽

pp. 1-5

Author(s):

Mehmet G. Ramoğlu ◽

Selen Karagözlü ◽

Özlem Bayram ◽

Jeyhun Bakhtiyarzada ◽

Alperen Aydın ◽

...

Keyword(s):

Troponin T ◽

Myocardial Dysfunction ◽

High Sensitivity ◽

Common Symptom ◽

C Reactive Protein ◽

Protein Levels ◽

Reactive Protein ◽

High Sensitivity Troponin ◽

High Sensitivity Troponin T ◽

Echocardiographic Findings

Abstract Objective: We aimed to evaluate the efficacy and role of high-sensitivity troponin T in children with a confirmed SARS-CoV-2 infection and also the correlation of troponin T levels with symptoms, and echocardiographic findings were analysed. Methods: Two hundred and fourteen patients with a confirmed SARS-CoV-2 infection between the dates of 28 March and 15 August 12020 were enrolled in this retrospective single-centre study. Patients with comorbidities and diagnosed as multisystem inflammatory syndrome in children were excluded. Demographic data, clinical and laboratory parameters were evaluated. The patients were classified and compared according to the troponin positivity. The correlation of troponin T with symptoms and echocardiographic findings was analysed. Results: The most common symptoms in the whole study group were fever (53.3%) and cough (24.8%). Troponin T levels were elevated in 15 (7%) patients. The most common symptom in patients with troponin positivity was also fever (73.3%). Troponin T positivity was significantly higher in patients under the age of 12 months and troponin T levels were negatively correlated with age. C-reactive protein levels were elevated in 77 (36%) of the patients in the whole group and 7 (46.7%) of 15 patients with troponin positivity. C-reactive protein levels were similar between groups. Conclusion: Routine troponin screening does not yield much information in previously healthy paediatric COVID-19 patients without any sign of myocardial dysfunction. Elevated troponin levels may be observed but it is mostly a sign of myocardial injury without detectable myocardial dysfunction in this group of patients.

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Prognostic value of plasma N-terminal pro-Brain natrituretic peptide and high sensitivity troponin T in patients with sepsis; correlation with C reactive protein level and 2D echocardiography

Indian Heart Journal ◽

10.1016/j.ihj.2014.10.335 ◽

2014 ◽

Vol 66 ◽

pp. S119

Author(s):

P.T. Suhail ◽

G. Vijayaraghavan ◽

V.K. Sureshkumar

Keyword(s):

Protein Level ◽

Prognostic Value ◽

Troponin T ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

High Sensitivity Troponin ◽

2D Echocardiography ◽

High Sensitivity Troponin T

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Remote Ischemic Preconditioning Applied during Isoflurane Inhalation Provides No Benefit to the Myocardium of Patients Undergoing On-pump Coronary Artery Bypass Graft Surgery

Anesthesiology ◽

10.1097/aln.0b013e318242349a ◽

2012 ◽

Vol 116 (2) ◽

pp. 296-310 ◽

Cited By ~ 98

Author(s):

Eliana Lucchinetti ◽

Lukas Bestmann ◽

Jianhua Feng ◽

Heike Freidank ◽

Alexander S. Clanachan ◽

...

Keyword(s):

Coronary Artery ◽

Brain Natriuretic Peptide ◽

Coronary Artery Bypass ◽

Natriuretic Peptide ◽

Troponin T ◽

Artery Bypass ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Pump Coronary Artery Bypass

Background Two preconditioning stimuli should induce a more consistent overall cell protection. We hypothesized that remote ischemic preconditioning (RIPC, second preconditioning stimulus) applied during isoflurane inhalation (first preconditioning stimulus) would provide more protection to the myocardium of patients undergoing on-pump coronary artery bypass grafting. Methods In this placebo-controlled randomized controlled study, patients in the RIPC group received four 5-min cycles of 300 mmHg cuff inflation/deflation of the leg before aortic cross-clamping. Anesthesia consisted of opioids and propofol for induction and isoflurane for maintenance. The primary outcome was high-sensitivity cardiac troponin T release. Secondary endpoints were plasma levels of N-terminal pro-brain natriuretic peptide, high-sensitivity C-reactive protein, S100 protein, and short- and long-term clinical outcomes. Gene expression profiles were obtained from atrial tissue using microarrays. Results RIPC (n = 27) did not reduce high-sensitivity cardiac troponin T release when compared with placebo (n = 28). Likewise, N-terminal pro-brain natriuretic peptide, a marker of myocardial dysfunction; high-sensitivity C-reactive protein, a marker of perioperative inflammatory response; and S100, a marker of cerebral injury, were not different between the groups. The incidence for the perioperative composite endpoint combining new arrhythmias and myocardial infarctions was higher in the RIPC group than the placebo group (14/27 vs. 6/28, P = 0.036). However, there was no difference in the 6-month cardiovascular outcome. N-terminal pro-brain natriuretic peptide release correlated with isoflurane-induced transcriptional changes in fatty-acid metabolism (P = 0.001) and DNA-damage signaling (P < 0.001), but not with RIPC-induced changes in gene expression. Conclusions RIPC applied during isoflurane inhalation provides no benefit to the myocardium of patients undergoing on-pump coronary artery bypass grafting.

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