NT-proBNP,cTnI,Hcy,DD and hs-CRP for the diagnosis of coronary heart disease by ROC curves

doi:10.3969/j.issn.1673-8640.2018.01.003

Abstract

Abstract:

Objective To evaluate the roles of N-terminal pro-B-type natriuretic peptide（NT-proBNP）,cardiac troponin I（cTnI）,homocysteine（Hcy）,D-dimer（DD） and high-sensitivity C-reactive protein （hs-CRP） for the diagnosis of coronary heart disease by receiver operating characteristic （ROC） curves. Methods A total of 87 patients with coronary heart disease were enrolled. There were 31 cases with acute myocardial infarction （AMI）,26 cases with unstable angina pectoris （UAP） and 30 cases with stable angina pectoris （SAP）. Totally,40 healthy subjects were enrolled as healthy control group. The levels of NT-proBNP and cTnI were determined by time-resolved immunofluorescence,DD and hs-CRP were determined by immunoturbidimetric assay,and Hcy was determined by enzymatic cycling assay. ROC curves were used to analyze optimal cut-off values,areas under curves（AUC）,sensitivities and specificities of NT-proBNP,cTnI,Hcy,DD and hs-CRP. Results The levels of NT- proBNP,cTnI,Hcy,DD and hs-CRP in coronary heart disease group were higher than those in healthy control group（P<0.05）. The increases of NT-proBNP,cTnI,Hcy,DD and hs-CRP from low to high in turn were SAP group,UAP group and AMI group（P<0.05）. The level of hs-CRP in SAP group was higher than that in healthy control group （P<0.05）,and there was no statistical significance for the other 4 indicators between the 2 groups（P>0.05）. The AUC of NT-proBNP,cTnI,Hcy,DD and hs-CRP in diagnosing coronary heart disease were 0.961,0.855,0.800,0.842 and 0.878,respectively. The optimal cut-off value of NT-proBNP was 321.00 ng/L,the sensitivity was 85.1%,and the specificity was 100.0%.Conclusions NT-proBNP,cTnI,Hcy,DD and hs-CRP can be used as valuable indicators in the diagnosis of coronary heart disease,and NT-proBNP is the most valuable.

Key words: N-terminal pro-B-type natriuretic peptide, Cardiac troponin I, Homocysteine, D-dimer, High-sensitivity C-reactive protein, Receiver operating characteristic curve, Coronary heart disease

CLC Number:

R446.1

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.

Figures/Tables 2

References 13

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组别	例数	NT-proBNP（ng/L）	cTnI（μg/L）
冠心病组	87	2 450（457~4 350）^*	0.160（0.016~0.460）^*
AMI组	31	4 670（3 900~7 640）^*#△	0.610（0.130~1.045）^*#△
UAP组	26	2 530（767~3 268）^*#	0.260（0.017~0.438）^*#
SAP组	30	416（138~662）	0.016（0.010~0.068）
正常对照组	40	86（57~124）	0.010（0.010~0.012）
组别	Hcy（μmol/L）	DD（μg/mL）	hs-CRP（mg/L）
冠心病组	17.94±9.73^*	0.78（0.36~1.78）^*	10.77（4.63~16.87）^*
AMI组	24.06±10.59^*#△	2.01（1.16~3.60）^*#△	17.00（10.85~27.84）^*#△
UAP组	17.51±8.62^*#	0.79（0.52~1.57）^*#	8.09（4.57~15.34）^*#
SAP组	11.99±4.88	0.37（0.29~0.59）	4.82（2.08~10.99）^*
正常对照组	9.28±3.38	0.28（0.20~0.38）	1.76（0.60~4.65）

组别	例数	NT-proBNP（ng/L）	cTnI（μg/L）
冠心病组	87	2 450（457~4 350）^*	0.160（0.016~0.460）^*
AMI组	31	4 670（3 900~7 640）^*#△	0.610（0.130~1.045）^*#△
UAP组	26	2 530（767~3 268）^*#	0.260（0.017~0.438）^*#
SAP组	30	416（138~662）	0.016（0.010~0.068）
正常对照组	40	86（57~124）	0.010（0.010~0.012）
组别	Hcy（μmol/L）	DD（μg/mL）	hs-CRP（mg/L）
冠心病组	17.94±9.73^*	0.78（0.36~1.78）^*	10.77（4.63~16.87）^*
AMI组	24.06±10.59^*#△	2.01（1.16~3.60）^*#△	17.00（10.85~27.84）^*#△
UAP组	17.51±8.62^*#	0.79（0.52~1.57）^*#	8.09（4.57~15.34）^*#
SAP组	11.99±4.88	0.37（0.29~0.59）	4.82（2.08~10.99）^*
正常对照组	9.28±3.38	0.28（0.20~0.38）	1.76（0.60~4.65）

项目	AUC（95%CI）	最佳临界值	敏感性（%）	特异性（%）
NT-proBNP	0.961（0.932~0.990）	321.00 ng/L	85.1	100.0
cTnI	0.855（0.792~0.919）	0.205 μg/L	65.5	97.5
Hcy	0.800（0.725~0.876）	14.45 μmol/L	55.2	95.0
DD	0.842（0.775~0.909）	0.475 μg/mL	67.8	90.0
hs-CRP	0.878（0.819~0.937）	3.65 mg/L	83.9	75.0

项目	AUC（95%CI）	最佳临界值	敏感性（%）	特异性（%）
NT-proBNP	0.961（0.932~0.990）	321.00 ng/L	85.1	100.0
cTnI	0.855（0.792~0.919）	0.205 μg/L	65.5	97.5
Hcy	0.800（0.725~0.876）	14.45 μmol/L	55.2	95.0
DD	0.842（0.775~0.909）	0.475 μg/mL	67.8	90.0
hs-CRP	0.878（0.819~0.937）	3.65 mg/L	83.9	75.0

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