Nt-probnp/troponin ratio for assessing myocardial dysfunction

Inactive Publication Date: 2010-10-07
ROCHE DIAGNOSTICS OPERATIONS
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Problems solved by technology

The diseases can remain asymptomatic for long periods of time.
However, they may have severe consequences once an acute cardiovascular event, such as myocardial infarction, as a cause of the cardiovascular disease occurs.
Even with the best therapy, heart failure is associated with an annual mortality of about 10%.
A patient having heart failure will not be able to fully restore his health without receiving a therapeutic treatment.
A symptomless myocardial dysfunction may, however, also develop into heart failure (which has to be treated in a therapy).
A myocardial dysfunction may, however, also be a heart failure, a chronic heart failure, even a severe chronic heart failure.
However, the diagnosis of heart failure under some medical circumstances based on NT-proBNP appears to be incorrect for a significant number of patients but not all (e.g., Beck 2004, Canadian Journal of Cardiology 20: 1245-1248; Tsuchida 2004, Journal of C

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Example 1

[0075]In a cohort of 166 patients showing acute MI, the levels of NT-proBNP, troponin T, CRP, GDF 15 and osteopontin were measured. Three months later, the levels of the same peptides were again determined. Patients having a low NT-proBNP / troponin T ratio had a weak or no pre-existing myocardial dysfunction, and a good restitution of the myocard functionality after three months. In contrast to this, patients having a high NT-proBNP / troponin T ratio showed a bad restitution of the myocard function after three months, and a pre-existing myocardial dysfunction.

[0076]NT-proBNP levels were determined with an immunoassay on an ELECSYS 2010 with a detection limit of 20 pg / ml.

[0077]The results of the study are shown in the following table:

41414242N = 1661. quartile2. quartile3. quartile4. quartileNT-proBNP / hsTnT-Ratio Timepoint 0Ratio,0.340.862.4610.35median(0.10-0.56)(0.56-1.27)(1.32-3.93)(4.10-285.02)(range)NT-proBNP624.10827.21216.53369[pg / ml],medianHs troponin1904.5980.4

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Abstract

The present invention relates to a method of diagnosing if a subject which has suffered from an acute myocardial infarction is also suffering from a pre-existing myocardial dysfunction, the method comprising a) determining the amount of a natriuretic peptide in a sample of the subject; b) determining the amount of a cardiac troponin in a sample of the subject; c) calculating the ratio (natriuretic peptide/cardiac troponin); and d) diagnosing if the elevated natriuretic peptide level is related to a preexisting myocardial dysfunction or if the elevated level is caused by the acute myocardial infarction, based on the ratio calculated in step c). The method allows determining whether the individual has suffered from a myocardial dysfunction, in particular heart failure, before the myocardial infarction has occurred.

Description

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Claims

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Application Information

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Owner ROCHE DIAGNOSTICS OPERATIONS
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