Cardiac biomarkers for diagnosing Takotsubo syndrome

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00098892%3A_____%2F24%3A10158732" target="_blank" >RIV/00098892:_____/24:10158732 - isvavai.cz</a>

Result on the web

<a href="https://academic.oup.com/eurheartj/article-abstract/45/25/2254/7667123?redirectedFrom=fulltext&login=false" target="_blank" >https://academic.oup.com/eurheartj/article-abstract/45/25/2254/7667123?redirectedFrom=fulltext&login=false</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/eurheartj/ehae231" target="_blank" >10.1093/eurheartj/ehae231</a>

Result language

angličtina

Original language name

Cardiac biomarkers for diagnosing Takotsubo syndrome

Original language description

Takotsubo syndrome (TTS) is characterized by transient left ventricular wall motion anomalies associated with coronary microvascular dysfunction in the absence of culprit lesions of epicardial coronary arteries. The clinical presentation of TTS resembles that of typical acute coronary syndrome (ACS). Despite coronary angiography being the gold standard for TTS diagnosis, its limitations and unessential role in disease management necessitate non-invasive diagnostic methods. Patients with TTS exhibit distinctive patterns of classic cardiac biomarkers compared to patients with ACS. Specifically, TTS is associated with higher brain natriuretic peptide (BNP) levels attributed to heightened filling pressures, and conversely, lower levels of troponin or creatine kinase (CK), as a consequence of distinct pathophysiological mechanisms. These variations in biomarker levels have been proposed as valuable indicators in differentiating these two entities from another. However, although previously proposed ratios of classic cardiac biomarkers exhibit promise in distinguishing TTS from ACS, their applicability was restricted by small sample sizes and a lack of validation. Thus, the present study aims to validate these ratios in the largest database dedicated to TTS worldwide, the International Takotsubo (InterTAK) Registry. In this study, involving patients from the world’s largest cohort of TTS patients, the efficacy of biomarker ratios in distinguishing TTS from ACS was found to be only moderately successful, with AUC values ranging from 0.5 to 0.8. Despite previous claims that these ratios could accurately differentiate between TTS and ACS, the originally anticipated excellent diagnostic accuracies could not be replicated in our international cohort of TTS patients. Although peak value ratios offer better distinction, the application of peak values in diagnostic ratios for cases with elevated ST-segments poses challenges, as immediate treatment is mandatory. Moreover, the integration of clinical variables and biomarkers holds significant promise for differentiating between the two entities with a higher level of diagnostic accuracy. The variability in the timing of blood collection across different centres for assessment of peak values should be acknowledged as a limitation of a large registry investigating a condition with low incidence, such as the InterTAK. However, measurement of admission values was performed according to international guidelines for the management of ACS. In conclusion, our study highlights the critical necessity for discovering novel biomarkers to enhance the diagnosis of TTS.

Czech name

—

Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European Heart Journal

ISSN

0195-668X

e-ISSN

1522-9645

Volume of the periodical

45

Issue of the periodical within the volume

25

Country of publishing house

GB - UNITED KINGDOM

Number of pages

5

Pages from-to

2254-2258

UT code for WoS article

001287642000001

EID of the result in the Scopus database

2-s2.0-85198544373