Delayed release of brain natriuretic peptide to identify myocardial ischaemia
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Delayed release of brain natriuretic peptide to identify myocardial ischaemia. / Zürcher, Stephan; Honegger, Ursina; Wagener, Max; Lee, Gino; Stallone, Fabio; Marxer, Tanja; Puelacher, Christian; Schumacher, Carmela; Sou, Seoung Mann; Twerenbold, Raphael; Reichlin, Tobias; Hochgruber, Thomas; Tanglay, Yunus; Freese, Michael; Wild, Damian; Rentsch, Katharina; Osswald, Stefan; Zellweger, Michael; Mueller, Christian.
in: EUR J CLIN INVEST, Jahrgang 45, Nr. 11, 11.2015, S. 1175-1183.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Delayed release of brain natriuretic peptide to identify myocardial ischaemia
AU - Zürcher, Stephan
AU - Honegger, Ursina
AU - Wagener, Max
AU - Lee, Gino
AU - Stallone, Fabio
AU - Marxer, Tanja
AU - Puelacher, Christian
AU - Schumacher, Carmela
AU - Sou, Seoung Mann
AU - Twerenbold, Raphael
AU - Reichlin, Tobias
AU - Hochgruber, Thomas
AU - Tanglay, Yunus
AU - Freese, Michael
AU - Wild, Damian
AU - Rentsch, Katharina
AU - Osswald, Stefan
AU - Zellweger, Michael
AU - Mueller, Christian
N1 - Publisher Copyright: © 2015 Stichting European Society for Clinical Investigation Journal Foundation.
PY - 2015/11
Y1 - 2015/11
N2 - Background: A recent pilot study suggested that exercise-induced myocardial ischaemia may lead to a delayed release of cardiac biomarkers, so that later sampling, for example, at 4 h after exercise could be used for diagnostic purpose. Materials and methods: In an observational study, we enrolled 129 consecutive patients referred for evaluation of a suspected coronary artery disease by rest/stress myocardial perfusion single-photon emission computed tomography. The treating cardiologist used all available clinical information to quantify clinical judgment regarding the presence of myocardial ischaemia using a visual analogue scale twice: prior and after stress testing. BNP levels were determined in a blinded fashion at rest, at peak stress and 4 h after peak stress. The presence of myocardial ischaemia was adjudicated based on perfusion single-photon emission computed tomography and coronary angiography findings by an independent cardiologist. Results: Myocardial ischaemia was detected in 58 patients (45%). Patients with myocardial ischaemia had significantly higher BNP levels at all times, compared to patients without ischaemia: BNP rest (99 vs. 61 pg/mL P = 0·007), BNP stress (125 vs. 77 pg/mL P = 0·02) and BNP 4 h (114 vs. 71 pg/mL P = 0·018). Diagnostic accuracy as quantified by the area under the receiver operating characteristics curve (AUC) was moderate for all time points (AUC 0·64-0·66). The change in BNP between rest and 4 h did not provide added value, neither to the baseline BNP level nor to clinical judgment. Conclusion: In contrast to our hypothesis, myocardial ischaemia did not lead to a differential delayed release of BNP. Late sampling did not seem clinically useful.
AB - Background: A recent pilot study suggested that exercise-induced myocardial ischaemia may lead to a delayed release of cardiac biomarkers, so that later sampling, for example, at 4 h after exercise could be used for diagnostic purpose. Materials and methods: In an observational study, we enrolled 129 consecutive patients referred for evaluation of a suspected coronary artery disease by rest/stress myocardial perfusion single-photon emission computed tomography. The treating cardiologist used all available clinical information to quantify clinical judgment regarding the presence of myocardial ischaemia using a visual analogue scale twice: prior and after stress testing. BNP levels were determined in a blinded fashion at rest, at peak stress and 4 h after peak stress. The presence of myocardial ischaemia was adjudicated based on perfusion single-photon emission computed tomography and coronary angiography findings by an independent cardiologist. Results: Myocardial ischaemia was detected in 58 patients (45%). Patients with myocardial ischaemia had significantly higher BNP levels at all times, compared to patients without ischaemia: BNP rest (99 vs. 61 pg/mL P = 0·007), BNP stress (125 vs. 77 pg/mL P = 0·02) and BNP 4 h (114 vs. 71 pg/mL P = 0·018). Diagnostic accuracy as quantified by the area under the receiver operating characteristics curve (AUC) was moderate for all time points (AUC 0·64-0·66). The change in BNP between rest and 4 h did not provide added value, neither to the baseline BNP level nor to clinical judgment. Conclusion: In contrast to our hypothesis, myocardial ischaemia did not lead to a differential delayed release of BNP. Late sampling did not seem clinically useful.
KW - Brain natriuretic peptide
KW - Exercise electrocardiography
KW - Myocardial ischaemia
UR - http://www.scopus.com/inward/record.url?scp=84945444903&partnerID=8YFLogxK
U2 - 10.1111/eci.12535
DO - 10.1111/eci.12535
M3 - SCORING: Journal article
C2 - 26331403
AN - SCOPUS:84945444903
VL - 45
SP - 1175
EP - 1183
JO - EUR J CLIN INVEST
JF - EUR J CLIN INVEST
SN - 0014-2972
IS - 11
ER -