Diagnostic Utility of Cardiac Biomarkers in Discriminating Takotsubo Cardiomyopathy From Acute Myocardial Infarction

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• 作者：M ; eep Singh R ; hawa ; Ashwat Singh Dhillon ; Harris C. Taylor ; Zhiyuan Sun ; Milind Y. Desai
• 关键词：Takotsubo cardiomyopathy ; cardiac biomarkers ; electrocardiogram and acute myocardial infarction
• 刊名：Journal of Cardiac Failure
• 出版年：January, 2014
• 年：2014
• 卷：20
• 期：1
• 页码：2-8
• 全文大小：494 K

文摘

Background

Takotsubo cardiomyopathy (TC) mimics acute myocardial infarction (AMI). We postulated that ventricular dysfunction in TC in the absence of significant myocardial necrosis would produce higher B-type natriuretic peptide (BNP)/troponin T (TnT) and BNP/creatine kinase MB fraction (CKMB) ratios than in AMI.

Methods and Results

We studied 58 consecutive TC (age 65.8 卤 82.9) and 97 AMI patients (age 59.8 卤 83.4). The ratios of BNP/TnT and BNP/CKMB were calculated with the use of first simultaneously drawn laboratory values. Receiver operating characteristic curves were used to distinguish TC from AMI with 95% specificity based on cardiac biomarker ratios. Median BNP/TnT and BNP/CKMB ratios were, respectively, 1,292 [interquartile range 443.4-2,657.9] and 28.44 [13.7-94.8] in the TC group and 226.9 [69.91-426.32] and 3.63 [1.07-10.02] in the AMI group (P < .001). TC can be distinguished from AMI with 95% specificity with the use of BNP/TnT ratio 鈮?,272 (sensitivity 52%) and BNP/CKMB ratio 鈮?9.9 (sensitivity 50%).

Conclusions

The value of BNP is significantly higher in TC than in AMI. Early BNP/TnT and BNP/CKMB ratios help to differentiate TC from AMI with greater accuracy than BNP alone.