Startseite High-sensitivity cardiac troponin T and N-terminal pro-B-type natriuretic peptide predict mortality in stable coronary artery disease: results from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study
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High-sensitivity cardiac troponin T and N-terminal pro-B-type natriuretic peptide predict mortality in stable coronary artery disease: results from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study

  • Evangelos Giannitsis , Eberhard Spanuth EMAIL logo , Andrea Horsch , Marcus E. Kleber , Winfried Koch , Tanja B. Grammer , Wolfgang Koenig und Winfried März
Veröffentlicht/Copyright: 27. September 2013
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Clinical Chemistry and Laboratory Medicine (CCLM)
Aus der Zeitschrift Clinical Chemistry and Laboratory Medicine (CCLM) Band 51 Heft 10

Abstract

Background: The simultaneous assessment of high-sensitivity cardiac troponin T (hscTnT) and NT-proBNP for predicting death in stable coronary artery disease (CAD) has yet not been examined. We investigated the additional contribution of hscTnT to the risk of mortality prediction of NT-proBNP in patients with stable CAD.

Methods: We studied 1469 patients with stable CAD enrolled in the Ludwigshafen Risk and Cardiovascular Health Study (LURIC). hscTnT and NT-proBNP were measured in baseline samples using immunoassays (Roche Diagnostics, Germany).

Results: Thirty-five percent (n=525) of the patients died during a median follow-up of 7 and a half years. In total 59.0% of the non-survivors and 25.2% of the survivors exhibited concentrations of hscTnT≥14 ng/L. Logistic regression analysis identified hscTnT and NT-proBNP as independent risk markers for short-term (1-year follow-up) and long-term (9-years follow-up) mortality. ROC curve analysis determined optimal univariate cut-offs at 14 ng/L and 443 µg/L for hscTnT (AUC 0.725, p<0.0001) and NT-proBNP (AUC 0.742, p<0.0001), respectively. Kaplan-Meier survival analysis based on optimized cut-offs for the simultaneous determination of both biomarkers confirmed the usefulness of additive hscTnT especially in prediction of short-term mortality. The prognostic benefit of the combined assessment of hscTnT and NT-proBNP could be confirmed by a significantly increased reclassification index (NRI) of 24.2%.

Conclusions: The majority of non-survivors exhibited increased hscTnT concentrations above 14 ng/L. The simultaneous determination of NT-proBNP and hscTnT was superior for risk stratification compared to determining either marker alone. Especially the prediction of the clinically important 1-year mortality was significantly improved by addition of hscTnT to NT-proBNP.

Keywords: high-sensitivity troponin T; net reclassification index (NRI); N-terminal pro-B-type natriuretic peptide (NT-proBNP); risk stratification; stable coronary artery disease
Corresponding author: Dr. Eberhard Spanuth, DIAneering, Diagnostics Engineering & Research GmbH, Firedrichstrasse 26, 69221 Heidelberg-Dossenheim, Germany, Phone: +49 6221 879634, Fax: +49 6221 879627, E-mail:

We thank Mrs. Simone Dietz, Mr. Carlbandro Edoga and Mr. René Schmidt-Ferroud for their excellent technical assistance. We are indebted to Drs. U. Neisen and A. Stief (Roche Diagnostics Germany GmbH, Mannheim, Germany) who provided the hscTnT and NT-proBNP immunoassays as free research support.

Conflict of interest statement

Authors’ conflict of interest disclosure: The authors stated that there are no conflicts of interest regarding the publication of this article. Research support played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Research funding: None declared

Employment or leadership: None declared

Honorarium: E. Giannitsis is a member of an advisory board of Roche Diagnostics and received honoraria for lectures from Roche Diagnostics. DIAneering® consulted to Roche Diagnostics and received honoraria. BDS Koch supported the statistical analysis and received honoraria from Roche Diagnostics.

Other authors have no conflict of interest to declare.

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Received: 2012-11-09
Accepted: 2013-05-15
Published Online: 2013-09-27
Published in Print: 2013-10-01

©2013 by Walter de Gruyter Berlin Boston

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  36. High-sensitivity cardiac troponin T and N-terminal pro-B-type natriuretic peptide predict mortality in stable coronary artery disease: results from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study
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https://doi.org/10.1515/cclm-2012-0786
Schlagwörter für diesen Artikel
high-sensitivity troponin T; net reclassification index (NRI); N-terminal pro-B-type natriuretic peptide (NT-proBNP); risk stratification; stable coronary artery disease

Artikel in diesem Heft

  1. Letters to the Editor
  2. Effect of hemoglobin Porto Alegre on glycated hemoglobin (HbA1c) measurement with the HA-8160 high performance liquid chromatography method
  3. Influence of sample type and delayed separation from cells on the measurement of B-type natriuretic peptide with the Architect system
  4. Efficient use of basic biochemical methods to prove the presence of monoclonal protein in the clinical diagnosis of malignant monoclonal gammopathy
  5. Ammonia does not interfere with the Diazyme adenosine deaminase test
  6. Interindividual variability of hemolysis in plasma samples during pneumatic tube system transport
  7. Kidney stones in a southeast European population from Bulgaria
  8. The influence of non-specificity of the creatinine assay on eGFR
  9. Reference values for alanine aminotransferase, α-amylase, aspartate aminotransferase, γ-glutamyltransferase and lactate dehydrogenase measured according to the IFCC standardization during uncomplicated pregnancy
  10. Congress Abstracts
  11. Congress of Clinical Chemistry and Laboratory Medicine / 10th Annual Meeting of the German Society for Clinical Chemistry and Laboratory Medicine (DGKL), Dresden, Germany, 23rd–26th October, 2013*)
  12. Masthead
  13. Masthead
  14. Editorials
  15. Stabilization of glucose in blood samples: out with the old, in with the new
  16. Component-resolved diagnostics: laboratory results are not enough
  17. Reviews
  18. Molecular basis and clonal evolution of myeloproliferative neoplasms
  19. Current and future use of “dried blood spot” analyses in clinical chemistry
  20. Opinion Papers
  21. Staging chronic kidney disease and estimating glomerular filtration rate: an opinion paper about the new international recommendations
  22. Age, stage and biomarkers for the definition of CKD: a construction in progress
  23. Guidelines and Recommendations
  24. Sampling and storage conditions influencing the measurement of parathyroid hormone in blood samples: a systematic review
  25. General Clinical Chemistry and Laboratory Medicine
  26. Citric/citrate buffer: an effective antiglycolytic agent
  27. Relationship between coffee consumption, oxidant status, and antioxidant potential in the Japanese general population
  28. Investigation of apparent non-albuminuric proteinuria in a primary care population
  29. Method-specific differences in plasma fibroblast growth factor 23 measurement using four commercial ELISAs
  30. Technical and clinical evaluation of the VITROS® Immunodiagnostic Products 25-OH Vitamin D Total Assay – comparison with marketed automated immunoassays and a liquid chromatography-tandem mass spectrometry method
  31. Isolated IgE reactivity to native walnut vicilin-like protein (nJug r 2) on ISAC™ microarray is due to cross-reactive carbohydrate epitopes
  32. Reference Values and Biological Variations
  33. A systematic review of data on biological variation for alanine aminotransferase, aspartate aminotransferase and γ-glutamyl transferase
  34. IDS iSYS automated intact procollagen-1-N-terminus pro-peptide assay: method evaluation and reference intervals in adults and children
  35. Cardiovascular Diseases
  36. High-sensitivity cardiac troponin T and N-terminal pro-B-type natriuretic peptide predict mortality in stable coronary artery disease: results from the Ludwigshafen Risk and Cardiovascular Health (LURIC) study
  37. Glycogen phosphorylase isoenzyme BB plasma kinetics is not related to myocardial ischemia induced by exercise stress echo test
  38. A novel method for the direct determination of heparin concentration during cardiopulmonary bypass surgery
  39. Diabetes
  40. External quality assessment of HbA1c and its effect on comparison between Swedish pediatric diabetes clinics. Experiences from the Swedish pediatric diabetes quality register (Swediabkids) and Equalis
  41. Infectious Diseases
  42. Presepsin (sCD14-ST) in preoperative diagnosis of abdominal sepsis
  43. Errata
  44. Recommendations for clinical laboratory science reports regarding properties, units, and symbols: the NPU format
  45. Standardization and analytical goals for glycated hemoglobin measurement
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