The application of combined detection of the NT-proBNP and cTnI in the diagnosis and treatment of acute heart failure patients

doi:10.3969/j.issn.1673-8640.2013.01.007

Abstract

Abstract: Objective　To investigate the application of combined detection of the N-terminal pro-B-type natriuretic peptide（NT-proBNP）and cardiac troponin I（cTnI）in the diagnosis and treatment of acute heart failure（HF）patients in emergency department. Methods　Enzyme-linked immunosorbent fluorescence assay was used to determine plasma NT-proBNP and cTnI levels in 708 patients with cardiovascular diseases（195 patients with HF and 513 patients with non-HF). Acoording to the New York Heart Assoeiation（NYHA）cardiac function grades，the HF patients were chassified into Grade Ⅰ-Ⅳ. The results were expressed by medians（quartiles). The results were analyzed statistically. Results　The levels of NT-proBNP and cTnI in HF group were 3 718（1 035-12 258）ng/L and 7.18（2.05-14.16）μg/L，respectively，which were significantly higher than those in [145（30-585）ng/L for NT-proBNP and 0.66（0.06-1.99）μg/L for cTnI，P＜0.01]. Statistical significance was also observed when comparing NT-proBNP and cTnI levels of the patients with HF at NYHA Grade Ⅱ，Ⅲ and Ⅳ （P＜0.05). Furthermore，the sensitivity（99%）and specificity（90%）for the diagnosis of HF with the combined detection of NT-proBNP and cTnI were much higher than those with either the detection of NT-proBNP or cTnI alone（P＜0.05). Conclusions　The combined detection of NT-proBNP and cTnI has valuable significance in the diagnosis and treatment of HF in emergency department.

Key words: N-terminal pro-brain natriuretic peptides, Cardiac troponin I, Cardiac Failure

ZHU Xiaopin，WANG Chenggang. The application of combined detection of the NT-proBNP and cTnI in the diagnosis and treatment of acute heart failure patients[J]. , 2013, 28(1): 30-32.

References

[1]Taylor JA，Christenson RH，Rao K，et al. B-type natriuretic peptide and N-terminal pro B-type natriuretic peptide are depressed in obesity despite higher left ventricular end diastolic pressures [J]. Am Heart J，2006，152(6)：1071-1076.
[2]Januzzi JL Jr，Chen-Tournoux AA，Moe G. Amino-terminal pro-B-type natriuretic peptide testing for the diagnosis or exclusion of heart failure in patients with acute symptoms[J]. Am J Cardiol，2008，101(3A):29-38.
[3]Chong CP，Lim WK，Velkoska E，et al. N-terminal pro-brain natriuretic peptide and angiotensin-converting enzyme-2 levels and their association with postoperative cardiac complications after emergency orthopedic surgery[J]. Am J Cardiol，2012，109(9)：1365-1373.
[4]Michtalik HJ，Yeh HC，Campbell CY，et al. Acute changes in N-terminal pro-B-type natriuretic peptide during hospitalization and risk of readmission and mortality in patients with heart failure[J]. Am J Cardiol，2011，107（8)：1191-1195.
[5]Van den Broek KC，Defilippi CR，Christenson RH，et al. Predictive value of depressive symptoms and B-type natriuretic peptide for new-onset heart failure and mortality[J]. Am J Cardiol，2011，107(5)：723-729.
[6]王跃荣，张栋梁，李岚，等. 慢性心力衰竭患者氨基末端B型钠尿肽与心肌肌钙蛋白I水平分析[J].检验医学，2011，26(7)：433-435.
[7]韩雪晶，贾克刚，吴小娟. B型钠尿肽、心肌肌钙蛋白I和高敏C反应蛋白在急性冠状动脉综合征中联合应用的研究[J].检验医学，2010，25(3)：210-213.
[8]廖予婕. cTnI、hs-CRP和BNP在心力衰竭患者治疗前后的变化及其对诊断和预后判断的价值[J]. 检验医学，2010，25(2)：92-95.
[9]Gale CP，Metcalfe E，West RM，et al. An assessment of the concentration-related prognostic value of cardiac troponin I following acute coronary syndrome[J]. Am J Cardiol，2011，108(9):1259-1265.

[1]	MA Jianguo, ZHU Xiaolin, DING Yongguang, YIN Meng, LI Hongchun. Predictive values of red blood cell distribution width and myocardial markers for acute myocardial infarction in patients with CAS [J]. Laboratory Medicine, 2022, 37(12): 1164-1168.
[2]	HE Chengshan, YAO Xiaoyang, JIANG Xiudi, LU Zhicheng. Microarray chemiluminescence immunoassay for quantitative detection of cardiac troponin I autoantibodies and preliminary clinical applications [J]. Laboratory Medicine, 2021, 36(3): 318-324.
[3]	SHU Ming, JIN Lu, CHEN Qiuying. Role of serum hepcidin in the diagnosis of myocardial damage among coronary heart disease patients [J]. Laboratory Medicine, 2019, 34(9): 783-786.
[4]	ZHENG Jianxin, YANG Hui, FU Qihua. Establishment of pediatric reference interval of cTnI in Shanghai based on rapid immunochromatography [J]. Laboratory Medicine, 2018, 33(10): 875-878.
[5]	YANG Yan, ZHANG Fujun, SHEN Songkun, WANG Houzhao. NT-proBNP,cTnI,Hcy,DD and hs-CRP for the diagnosis of coronary heart disease by ROC curves [J]. Laboratory Medicine, 2018, 33(1): 15-19.
[6]	WANG Qijun, CHEN Pei, ZENG Qinfei, CHEN Pingping, YING Luman, CAO Jianming, CEN Dong. Correlationship research of ischemia modified albumin in patients with early acute myocardial infarction [J]. , 2014, 29(8): 817-821.
[7]	CHEN Donglian, ZENG Fanpeng, DU Zhilin, LUO Weiping, LIANG Miaozhi, YANG Ying.. Investigation on the clinical significance of BNP and cTnI detections in AMI patients with non-diabetic irritable hyperglycosemia [J]. , 2014, 29(1): 57-60.
[8]	TANG Hongxia, JIA Kegang, HAN Xuejing, HE Cong, SHANG Ziyi, ZHEN Li. Evaluation on the analysis performance of high sensitive cardiac troponin I detected by PATHFAST [J]. , 2013, 28(7): 611-617.
[9]	HAN Xuejing，TANG Hongxia，ZHEN Li，SHANG Ziyi，YANG Yongpeng，JIA Kegang. Establishment and evaluation of detection limits and function sensitivity of high-sensitivity assays for cardiac troponin I [J]. , 2013, 28(2): 97-101.
[10]	HE Yan;LI Furong;DU Zongxiao;PIAO Wenhua. The clinical significance on the combined detection of the serum BNP，hs-CRP，cTnI and UA in heart failure [J]. , 2012, 27(8): 647-650.
[11]	ZHANG Guang-Hui;DENG Lin;FEI Ai-Hua;DAI Li-Hua;LU Yi-Wen;SHEN Li-Song. Application of enhanced cardiac troponin I determination in clinical diagnosis of acute coronary syndrome [J]. , 2012, 27(5): 345-348.
[12]	WU Weihua;YI Jianhua. Investigation on the complementation significance of combined cTnI，IMA and hs-CRP determination in coronary heart disease [J]. , 2012, 27(5): 361-363.
[13]	LIN Gaogui;MENG Fanchao;ZENG Yunxiang;ZHAO Chun. The significance of heart-type fatty acid-binding protein for early diagnosis of acute myocardial infarction [J]. , 2012, 27(4): 280-283.
[14]	YAN Guochao;SHAO Yun;WU Yan;QI Guoqing. The research of myocardial damage in children with congenital heart diseases before and after paediatric cardiovascular intervention [J]. , 2012, 27(2): 135-137.
[15]	HAN Xuejing;JIA Kegang;WU Xiaojuan. Research on the combined determination of B-type natriuretic peptide,cardiac troponin I and high sensitive C reactive protein in acute coronary syndrome [J]. , 2010, 25(03): 210-213.