Cardiac biomarkers for diagnosing Takotsubo syndrome

Kód výsledku v 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>

Výsledek na webu

<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>

Jazyk výsledku

angličtina

Název v původním jazyce

Cardiac biomarkers for diagnosing Takotsubo syndrome

Popis výsledku v původním jazyce

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.

Název v anglickém jazyce

Cardiac biomarkers for diagnosing Takotsubo syndrome

Popis výsledku anglicky

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.

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

—

OECD FORD obor

30201 - Cardiac and Cardiovascular systems

Projekt

—

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2024

Kód důvěrnosti údajů

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

Název periodika

European Heart Journal

ISSN

0195-668X

e-ISSN

1522-9645

Svazek periodika

45

Číslo periodika v rámci svazku

25

Stát vydavatele periodika

GB - Spojené království Velké Británie a Severního Irska

Počet stran výsledku

5

Strana od-do

2254-2258

Kód UT WoS článku

001287642000001

EID výsledku v databázi Scopus

2-s2.0-85198544373