Journal article

Publication year: 2015

Pages: 1532-1539

Journal: Clinical Chemistry

Volume number: 61

Issue number: 12

ISSN: 0009-9147

eISSN: 1530-8561

Open access status: Bronze

DOI Link: https://doi.org/10.1373/clinchem.2015.244327

Publisher: Oxford University Press

Abstract: 

BACKGROUND: The signal peptide for human B-type natriuretic peptide preprohormone (BNPsp), which is released from cardiomyocytes, is increased in plasma of patients with acute myocardial infarction (AMI); however, its exact release kinetics have not been defined.

METHODS: We measured BNPsp and high-sensitivity cardiac troponin T (hs-cTnT) in a reference group of individuals without structural heart disease (n = 285) and determined the release kinetics of these biomarkers in patients (n = 29) with hypertrophic obstructive cardiomyopathy undergoing transcoronary ablation of septal hypertrophy (TASH), a procedure allowing exact timing of onset of iatrogenic AMI. Blood samples were collected before TASH and at numerous preselected time points after TASH.

RESULTS: The reference median BNPsp concentration was 53.4 pmol/L [interquartile range (IQR) 47.0-61.0; 95th percentile 85.9 pmol/L; 99th percentile 116.3 pmol/L]. Baseline concentrations in patients undergoing TASH were higher than in the reference group [91.9 pmol/L (IQR 62.9-116.4); P < 0.0001]. BNPsp increased significantly, peaking at 15 min after induction of AMI [149.6 pmol/L (109.5-204.9) vs baseline; P = 0.004] and declining slowly thereafter, falling below the preprocedural value after 8 h (P = 0.014). hs-cTnT increased significantly 15 min after induction of AMI [26 ng/L (19-39) vs 18 ng/L (11-29); P = 0.001] and remained high at all later time points.

CONCLUSIONS: BNPsp concentrations increased immediately after AMI induction, providing early evidence of myocardial injury. The release kinetics of BNPsp differed from those of hs-cTnT. These findings provide information that should help in establishing the diagnostic value of BNPsp in the setting of early AMI. (C) 2015 American Association for Clinical Chemistry

Harvard Citation style: Liebetrau, C., Gaede, L., Doerr, O., Blumenstein, J., Rosenburg, S., Hoffmann, J., et al. (2015) Reference Values and Release Kinetics of B-Type Natriuretic Peptide Signal Peptide in Patients with Acute Myocardial Infarction, Clinical Chemistry, 61(12), pp. 1532-1539. https://doi.org/10.1373/clinchem.2015.244327

APA Citation style: Liebetrau, C., Gaede, L., Doerr, O., Blumenstein, J., Rosenburg, S., Hoffmann, J., Troidl, C., Harnm, C., Nef, H., Moellmann, H., Richards, A., & Pemberton, C. (2015). Reference Values and Release Kinetics of B-Type Natriuretic Peptide Signal Peptide in Patients with Acute Myocardial Infarction. Clinical Chemistry. 61(12), 1532-1539. https://doi.org/10.1373/clinchem.2015.244327