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The diagnostic significance of NT-proBNP and troponin I in emergency department patients presenting with palpitations

2013; Elsevier BV; Volume: 68; Issue: 4 Linguagem: Inglês

10.6061/clinics/2013(04)17

1980-5322

Tarık Ocak, Alim Erdem, Arif Duran, Ümit Yaşar Tekelioğlu, Serkan Öztürk, Suzi Selim Ayhan, Mehmet Fatih Özlü, Mehmet Tosun, Hasan Koçoğlu, Mehmet Yazıcı,

Cardiac, Anesthesia and Surgical Outcomes

OBJECTIVE: This prospective study investigated the diagnostic significance of the N-terminal pro-brain natriuretic (NT-proBNP) and troponin I peptides in emergency department patients presenting with palpitations.METHODS: Two groups of patients with palpitations but without documented supraventricular tachycardia were compared: a group with supraventricular tachycardia (n = 49) and a control group (n = 47).Both groups were diagnosed using electrophysiological studies during the study period.Blood samples were obtained from all of the patients to determine the NT-proBNP and troponin I levels within the first hour following arrival in the emergency department.RESULT: The mean NT-proBNP levels were 207.74¡197.11 in supraventricular tachyarrhythmia group and 39.99¡32.83pg/mL in control group (p,0.001).To predict supraventricular tachycardia, the optimum NT-proBNP threshold was 61.15 pg/mL, as defined by the receiver operating characteristic (ROC) curve, with a non-significant area under the ROC curve of 0.920 (95% CI, 0.86-0.97,p,0.001).The NT-proBNP cut-off for diagnosing supraventricular tachycardia had 81.6% sensitivity and 91.5% specificity.Supraventricular tachycardia was significantly more frequent in the patients with NT-proBNP levels $61.15 pg/mL (n = 44, 90.9%, p.0.001).The mean troponin I levels were 0.17¡0.56 and 0.01¡0.06pg/mL for the patients with and without supraventricular tachycardia, respectively (p,0.05).Of the 96 patients, 21 (21.87%) had troponin I levels $0.01: 2 (4.25%) in the control group and 19 (38.77%) in the supraventricular tachycardia group (p,0.001).CONCLUSION: Troponin I and, in particular, NT-proBNP peptide were helpful for differentiating supraventricular tachycardia from non-supraventricular tachycardia palpitations.Further randomized, large, multicenter trials are needed to define the benefit and diagnostic role of NT-proBNP and troponin I in the management algorithm of patients presenting with palpitations in emergency departments.