Reference : Ratio of high-sensitivity troponin to creatine kinase-MB in takotsubo syndrome.
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/2268/221755
Ratio of high-sensitivity troponin to creatine kinase-MB in takotsubo syndrome.
English
Pirlet, Charles [> >]
Pierard, Luc mailto [Université de Liège > Département des sciences cliniques > Cardiologie - Pathologie spéciale et réhabilitation >]
Legrand, Victor mailto [Université de Liège > Département des sciences cliniques > Département des sciences cliniques >]
Gach, Olivier [Université de Liège > Département des sciences cliniques > Département des sciences cliniques >]
2017
International Journal of Cardiology
Yes (verified by ORBi)
International
0167-5273
1874-1754
Netherlands
[en] Biomarkers ; Creatine kinase-MB ; High-sensitivity troponin T ; Takotsubo
[en] BACKGROUND: Takotsubo syndrome (TT) and myocardial infarction (MI) share numerous similarities in clinical presentation, ECG modifications and biomarker elevation. We sought to determine whether the ratio of high-sensitivity cardiac troponin T (hs-TnT) to the myocardial fraction of creatine kinase (CKMB) could be a potent discriminator between TT and MI patients. METHODS: We separately present analysis of data from retrospective files and prospectively recruited patients presenting with TT (35 retrospective and 42 prospective), NSTEMI (48 retrospective and 75 prospective) and STEMI (20 retrospective and 39 prospective). We compared ratios of hs-TnT to CKMB on admission to the hospital between TT, NSTEMI and STEMI patients. Receiver operating characteristic (ROC) curves were analysed to determine optimal cut-off values. RESULTS: On admission, hs-TnT/CKMB ratio was significantly higher in TT patients than in NSTEMI and STEMI patients in both the retrospective phase (median and interquartile range, TT 0.024 [0.018-0.047] vs NSTEMI 0.009 [0.006-0.022], p<0.0001; TT vs STEMI 0.011 [0.006-0.016], p=0.0002) and the prospective cohort (median and interquartile range, TT 0.032 [0.018-0.040] vs NSTEMI 0.009 [0.006-0.015], p<0.0001; TT vs STEMI 0.009 [0.005-0.017], p<0.0001). A cut-off hs-TnT/CKMB ratio of 0.015 distinguished TT from MI with a sensitivity of 85.7% and a specificity of 67.6% (AUC 0.796; 95%CI: 0.71-0.89) in the retrospective phase. In the prospective phase, a ratio of 0.017 distinguished TT from MI with a sensitivity of 83.3% and a specificity of 78.1% (AUC 0.88; 95%CI: 0.83-0.94). CONCLUSION: hs-TnT/CKMB ratio is a novel, readily available parameter that could be used alongside clinical risk scores, other biomarkers and ECG findings to discriminate between TT and MI.
http://hdl.handle.net/2268/221755
10.1016/j.ijcard.2017.05.107
Copyright (c) 2017 Elsevier Ireland Ltd. All rights reserved.

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