Serum Cardiac Troponins and N-Terminal Pro-Brain Natriuretic Peptide: A Staging System for Primary Systemic Amyloidosis

2004 ◽  
Vol 22 (18) ◽  
pp. 3751-3757 ◽  
Author(s):  
Angela Dispenzieri ◽  
Morie A. Gertz ◽  
Robert A. Kyle ◽  
Martha Q. Lacy ◽  
Mary F. Burritt ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Troponin T ◽  
Elevated Serum ◽  
Staging System ◽  
Systemic Amyloidosis ◽  
Prognostic Models ◽  
Plasma Cell Dyscrasia

Purpose Primary systemic amyloidosis (AL) is a multisystemic disorder resulting from an underlying plasma cell dyscrasia. There is no formal staging system for AL, making comparisons between studies and treatment centers difficult. Our group previously identified elevated serum cardiac troponin T (cTnT) as the most powerful predictor of overall survival. Others have reported that N-terminal pro-brain natriuretic peptide (NT-proBNP) is a valuable prognostic marker. We sought to develop a staging system for patients with AL. Patients and Methods Two hundred forty-two patients with newly diagnosed AL who were seen at the Mayo Clinic between April 1979 and November 2000, and who had echocardiograms and stored serum samples at presentation were eligible for this retrospective review. NT-proBNP measurements were performed on 242 patients in whom cTnT and cardiac troponin I (cTnI) had been previously run. Two prognostic models were designed using threshold values of NT-proBNP and either cTnT or cTnI (NT-proBNP < 332 ng/L, cTnT < 0.035 μg/L, and cTnI < 0.1 μg/L). Depending on whether NT-proBNP and troponin levels were both low, were high for only one level, or were both high, patients were classified as stage I, II, or III, respectively. Results Using the cTnT+NT-proBNP model 33%, 30%, and 37% of patients were stages I, II, and III, respectively, with median survivals of 26.4, 10.5, and 3.5 months, respectively. The alternate cTnI+NT-proBNP model predicted median survivals of 27.2, 11.1, and 4.1 months, respectively. Conclusion Stratification of AL patients into three stages is possible with two readily available and reproducible tests setting the stage for more consistent and reliable cross comparisons of therapeutic outcomes.

scholarly journals Combined Measurements of Cardiac Troponin T and N-Terminal Pro-Brain Natriuretic Peptide in Patients With Heart Failure

2004 ◽  
Vol 68 (12) ◽  
pp. 1160-1164 ◽  
Author(s):  
Ryoji Taniguchi ◽  
Yukihito Sato ◽  
Tasuku Yamada ◽  
Muneo Ooba ◽  
Hirokazu Higuchi ◽  
...  
Keyword(s):  
Heart Failure ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin T ◽  
Cardiac Troponin T ◽  
Patients With Heart Failure ◽  
Combined Measurements

Abstract 2550: N-terminal Pro-brain Natriuretic Peptide-defined Cardiomyopathy in Doxorubicin-treated Children with Acute Lymphoblastic Leukemia

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Steven E Lipshultz ◽  
Stuart R Lipsitz ◽  
Rebecca E Scully ◽  
Tracie L Miller ◽  
Elly Barry ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Troponin T ◽  
Lymphoblastic Leukemia ◽  
Elevated Serum ◽  
Left Ventricular ◽  
Serum Samples ◽  
Irreversible Damage ◽  
Fractional Shortening

Background: Doxorubicin damages heart muscle, placing long-term survivors of childhood cancer at elevated risk of cardiac dysfunction. N-terminal pro-brain natriuretic peptide (NT-proBNP), an independent predictor of mortality and cardiovascular events in other populations, may serve to indicate cardiomyopathy prior to irreversible damage in this population. Methods: To determine the diagnostic value of NT-proBNP in children receiving doxorubicin, the NCI Dana-Farber Cancer Institute ALL Consortium collected serial serum samples and echocardiograms from children with ALL between 1995 and 2000 randomized to receive doxorubicin alone (dox; n = 74; 1203 samples; median age = 6.4 yrs; 30 mg/m 2 /dose for 10 doses) or doxorubicin preceded by the cardioprotectant dexrazoxane (dex/dox; n = 80; 1338 samples; median age = 7.1 yrs; 300 mg/m 2 /dose). Results: Marked NT-proBNP elevation (NT-proBNP ≥ 100 pg/ml if age ≥ 1; proBNP ≥ 150 pg/ml if age > 1) was seen at baseline (treatment day 0; dox alone = 82.5% of patients abnormal; dex/dox = 87.4%; p = 0.527). During treatment, the percentage of patients with abnormal NT-proBNP levels fell to a minimum of 35.8% in the dox only group and 16.4% in the dex/dox group ( p < 0.001) before rising progressively at the end of treatment (treatment day 220; dox only = 70.8%; dex/dox = 5.3%; p < 0.001). After controlling for treatment, a patient with abnormal NT-proBNP six months after the start of doxorubicin had 2.39 times the odds of having myocardial injury as indicated by elevated cardiac troponin T (cTnT ≥0.01 ng/mL; OR = 2.39; 95%CI 1.156 - 4.946; p = 0.019). Further, at any given time and for either treatment, a patient with abnormal NT-proBNP had 2.36 times the odds of having abnormal LV fractional shortening (OR = 2.36; 95%CI 1.026 - 5.449; p = 0.047). Conclusion: Elevated serum NT-proBNP was significantly related to cumulative unprotected doxorubicin dose, left ventricular fractional shortening, and cTnT during doxorubicin therapy. A much higher percentage of patients exhibited levels of NT-proBNP suggestive of cardiomyopathy than showed death of cardiomyocytes as indicated by elevated cTnT levels. This might allow the testing of individualized preventative therapy for cancer patients at high risk for long-term cardiotoxicity.

scholarly journals Factors associated with increased levels of brain natriuretic peptide and cardiac troponin I during the peripartum period

PLoS ONE ◽  
2019 ◽  
Vol 14 (2) ◽  
pp. e0211982
Author(s):  
Yuki Kimura ◽  
Takao Kato ◽  
Hiromi Miyata ◽  
Issei Sasaki ◽  
Eri Minamino-Muta ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Cardiac Troponin I ◽  
Factors Associated ◽  
Peripartum Period

Distribution of soluble suppression of tumorigenicity 2 (sST2), N-terminal pro-brain natriuretic peptide (NT-proBNP), high sensitive troponin I and high-sensitive troponin T in umbilical cord blood

2016 ◽  
Vol 54 (11) ◽  
Author(s):  
Hanah Kim ◽  
Ji Myung Kim ◽  
Mina Hur ◽  
Mi-Kyung Park ◽  
Hee-Won Moon ◽  
...  
Keyword(s):  
Brain Natriuretic Peptide ◽  
Cord Blood ◽  
Natriuretic Peptide ◽  
Umbilical Cord Blood ◽  
Apgar Score ◽  
Troponin I ◽  
Troponin T ◽  
Cardiac Markers ◽  
Term Neonates ◽  
High Sensitive Troponin

AbstractBackground:Soluble suppression of tumorigenicity 2 (sST2), N-terminal pro-brain natriuretic peptide (NT-proBNP), high sensitive troponin I (hs-TnI), and high sensitive troponin T (hs-TnT) are representative cardiac biomarkers. The reference intervals (RIs) of these biomarkers have been rarely investigated in umbilical cord blood (UCB). We explored the distribution of these cardiac markers and established their RIs in UCB.Methods:In a total of 293 UCB specimens, sST2, NT-proBNP, hs-TnI, and hs-TnT concentrations were analyzed according to the gestational age, presence of premature membrane rupture (PROM), presence of gestational diabetes mellitus (GDM), and Apgar score at 1 min. Their RIs were defined in 133 UCB specimens from healthy, full-term neonates, using non-parametric percentile methods according to the Clinical and Laboratory Standards Institute guideline (EP28-A3C).Results:The concentrations of four cardiac markers in UCB were different between full-term neonates and pre-term neonates. The concentrations of NT-proBNP and hs-TnI differed according to the presence or absence of PROM. Their concentrations did not differ regardless of the presence of GDM. The concentrations of sST2 and NT-proBNP differed according to the Apgar score at 1 min. The 97.5th percentile upper reference limits were: sST2, 59.9 ng/mL; NT pro-BNP, 1415.3 pg/mL; hs-TnI, 27.8 pg/mL; and hs-TnT, 86.5 pg/mL.Conclusions:The distribution of sST2, NT pro-BNP, hs-TnI, and hs-TnT in UCB together with their RIs would provide fundamental data for future researches and clinical practice.

scholarly journals Biomarkers of Atrial Fibrillation: Which One Is a True Marker?

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Pipin Ardhianto ◽  
Yoga Yuniadi
Keyword(s):  
Atrial Fibrillation ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Troponin I ◽  
Coronary Artery Stenosis ◽  
Troponin T ◽  
Troponin Elevation ◽  
Brain Natriuretic Peptides ◽  
Prognostic Stratification ◽  
Future Events

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmias and associated with the risk of stroke and death. Continuous development of the diagnostic tool and prognostic stratification may lead to optimal management of AF. The use of biomarkers in the management of AF has been grown as an interesting topic. However, the AF biomarkers are not yet well established in the major guidelines. Among these biomarkers, a lot of data show troponin and brain natriuretic peptides are promising for the prediction of future events. The troponin elevation in AF patients may not necessarily be diagnosed as myocardial infarction or significant coronary artery stenosis, and brain natriuretic peptide elevation may not necessarily confirm heart failure. Troponin T and troponin I may predict postoperative AF. Furthermore, troponin and brain natriuretic peptide gave better prognostic performance when compared with the risk score available today.

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