Concentrations of N-terminal pro-brain natriuretic peptide and troponin T in plasma of 75-year-old apparently healthy persons
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Abstract
Clinical chemical reference values for older persons are sparse and mostly intermixed with those for younger persons. We had a unique opportunity to obtain blood samples from volunteers who were 75years old and living in two districts of Vienna, Austria. Consequently, we utilized stored plasma samples to obtain reference intervals for 120 apparently healthy 75-year-old participants for pro-brain natriuretic peptide (proBNP), as well as for troponin T. The N-terminal (NT)-proBNP protein assay is currently used as a diagnostic and prognostic aid in patients with heart failure and as a prognostic marker in acute coronary syndromes. Specifically, the concentration of NT-proBNP in serum or plasma aids in the prognosis of ventricular systolic dysfunction and helps to differentiate between cardiac and non-cardiac causes. The median NT-proBNP plasma value for men and women in our cohort was calculated as 98pg/ml, comparing favorably with reported values, in that a NT-proBNP concentration less than 100pg/ml excludes acutely decompensated heart failure. Our calculated 97.5 percentile was slightly higher (359 pg/ml) than the 97.5 percentile in a group of 50–65-year-old persons (198 and 222pg/ml for men and women, respectively) revealing the influence of age on this parameter. Because of its high tissue-specificity, cardiac troponin T is a cardiospecific, highly sensitive marker for myocardial damage. However, the troponin T concentrations in the plasma specimens from this cohort were all below the detection limit of 0.01ng/ml, preventing any further data handling.
References
1 McCullough PA, Sandberg KR. Sorting out the evidence on natriuretic peptides. Rev Cardiovasc Med 2003; 4:Suppl 4:S13–9.Search in Google Scholar
2 Fischer P, Jungwirth S, Krampla W, Weissgram S, Kirchmeyr W, Schreiber W, et al. Vienna TransDanube Aging ‘VITA’: study design, recruitment strategies and level of participation. J Neural Transm 2002; 62:Suppl:105–16.10.1007/978-3-7091-6139-5_11Search in Google Scholar
3 Sasse EA. Reference intervals and clinical decision limits. In: Kaplan LA, Pesce AJ, editors. Clinical chemistry. St. Louis: Mosby, 1996:365–81.Search in Google Scholar
4 Solberg HE. Approved recommendation (1986) on the theory of reference values. Part I. The concept of reference values. Clin Chim Acta 1987;165:111–18, J Clin Chem Clin Biochem 1987;25:337–42, Ann Biol Clin 1987;45:237–41, Labmedica 1987; 4:27–31.10.1016/0009-8981(87)90224-5Search in Google Scholar
5 PetitClerc C, Solberg HE. Approved recommendation (1987) on the theory of reference values. Part 2. Selection of individuals for the production of reference values. J Clin Chem Clin Biochem 1987;25:639–44, Clin Chim Acta 1987; 170:S3–12.Search in Google Scholar
6 Solberg HE, PetitClerc C. Approved recommendation (1988) on the theory of reference values. Part 3. Preparation of individuals and collection of specimens for the production of reference values. Clin Chim Acta 1988; 177:S1–12.Search in Google Scholar
7 Solberg HE, Stamm D. Approved recommendation on the theory of reference values. Part 4. Control of analytical variations in the production, transfer and application of reference values. Clin Chim Acta 1991;202: S5–12, Eur J Clin Chem Clin Biochem 1991; 29:531–5.Search in Google Scholar
8 Hunt PJ, Richards AM, Nicholls MG, Yandle DG, Doughty RN, Espiner EA. Immunoreactive aminoterminal pro-brain natriuretic peptide (NT-PROBNP): a new marker for cardiac impairment. Clin Endocrinol 1997; 47:287–96.10.1046/j.1365-2265.1997.2361058.xSearch in Google Scholar
9 Struthers AD. How to use natriuretic peptide levels for diagnosis and prognosis. Eur Heart J 1999; 20:1374–5.10.1053/euhj.1999.1771Search in Google Scholar
10 Roche Diagnostics Inc. Supplement documentation. Elecsys proBNP reagent kit, catalog number 03121640122. Mannheim, Germany: Roche, 2004.Search in Google Scholar
11 Yeo KT, Wu AH, Apple FS, Kroll MH, Christenson RH, Lewandrowski KB, et al. Multicenter evaluation of the Roche NT-proBNP assay and comparison to the Biosite Triage BNP assay. Clin Chim Acta 2003; 338:107–15.10.1016/j.cccn.2003.08.016Search in Google Scholar
12 Wu AH, Packer M, Smith A, Bijou R, Fink D, Mair J, et al. Analytical and clinical evaluation of the Bayer ADVIA Centaur automated B-type natriuretic peptide assay in patients with heart failure: a multisite study. Clin Chem 2004; 50:867–73.10.1373/clinchem.2003.026138Search in Google Scholar
13 Solberg HE. Approved recommendation (1987) on the theory of reference values. Part 5. Statistical treatment of collected reference values. Determination of reference limits. Clin Chim Acta 1987;170:S33–42, J Clin Chem Clin Biochem 1987; 25:645–56.10.1016/0009-8981(87)90151-3Search in Google Scholar
14 Horn PS, Feng L, Li Y, Pesce AJ. Effect of outliers and nonhealthy individuals on reference interval estimation. Clin Chem 2001; 47:2137–45.10.1093/clinchem/47.12.2137Search in Google Scholar
15 Dixon WJ. Processing data for outliers. Biometrics 1953; 9:74–9.10.2307/3001634Search in Google Scholar
16 Talwar S, Squire IB, Davies JE, Barnett DB, Ng LL. Plasma N-terminal pro-brain natriuretic peptide and the ECG in the assessment of left ventricular systolic dysfunction in a high risk population. Eur Heart J 1999; 20:1736–44.10.1053/euhj.1999.1694Search in Google Scholar PubMed
17 Raymond I, Groenning BA, Hildebrandt PR, Nilsson JC, Baumann M, Trawinski J, Pederson F. The influence of age, sex and other variables on the plasma level of N-terminal pro brain natriuretic peptide in a large sample of the general population. Heart 2003; 89:745–51.10.1136/heart.89.7.745Search in Google Scholar
18 Johnston N, Jernberg T, Lindahl B, Lindback J, Stridsberg M, Larsson A, et al. Biochemical indicators of cardiac and renal function in a healthy elderly population. Clin Biochem 2004; 37:210–6.10.1016/j.clinbiochem.2003.11.002Search in Google Scholar
19 Alpert JS, Thygesen K. Myocardial infarction redefined – a consensus document of the joint European Society of Cardiology/American College of Cardiology committee for the redefinition of myocardial infarction. J Am Coll Cardiol 2000; 36:959–69.10.1016/S0735-1097(00)00804-4Search in Google Scholar
20 Tietz NW, Shuey DF, Wekstein DR. Laboratory values in fit aging individuals – sexagenarians through centenarians. In: Faulkner WR, Meites S, editors. Geriatric clinical chemistry. Washington: AACC Press, 1994.Search in Google Scholar
©2004 by Walter de Gruyter Berlin New York
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Articles in the same Issue
- Contents
- Author Index
- Subject Index
- Hematopoietic cytokines as tumor markers
- The apoB/apoA-I ratio is better than the cholesterol ratios to estimate the balance between plasma proatherogenic and antiatherogenic lipoproteins and to predict coronary risk
- Rapid combined genotyping of factor V, prothrombin and methylenetetrahydrofolate reductase single nucleotide polymorphisms using minor groove binding DNA oligonucleotides (MGB probes) and real-time polymerase chain reaction
- Methylenetetrahydrofolate reductase gene A222V polymorphism and risk of ischemic stroke
- Determination of asymmetric dimethylarginine (ADMA) using a novel ELISA assay
- The assessment of bone metabolism in female elite endurance athletes by biochemical bone markers
- Declines in serum free and bound choline concentrations in humans after three different types of major surgery
- Analysis of inflammatory response in human plasma samples by an automated multicapillary electrophoresis system
- Multicenter evaluation of the commutability of a potential reference material for harmonization of enzyme activities
- HDL and clinical and biochemical correlates in Italian non-smoker women
- Hyperhomocysteinaemia is associated with uveitis but not with deep venous thrombosis in Behçet's disease
- Production of gender-specific morning salivary cortisol reference intervals using internationally accepted procedures
- Concentrations of N-terminal pro-brain natriuretic peptide and troponin T in plasma of 75-year-old apparently healthy persons
- External Quality Assessment for biochemical markers of myocardial damage: an Italian experience
- Further evaluation of the immunonephelometric assay of soluble transferrin receptor and assessment of pediatric values in southern Italy
- Exercise raises serum heat-shock protein 70 (Hsp70) levels
- Hepatitis C-associated complement cold activation
- The relationship between cryoglobulins and HCV-RNA in the serum of patients infected with different HCV genotypes
- Artificial neural network-based algorithm for the evaluation of serum protein capillary electrophoresis
- State-of-the-art systematic error for therapeutic drug monitoring
- Peculiarities and problems with the EXCEL® F-test
- Questionable results – should EQA results be accepted as submitted or should ‘obvious mistakes’ be corrected?. Reply to Wood WG. Questionable results – who directs the EQAS organisers? CCLM 2004;42(9):1073
- Erratum
