Journalartikel

Jahr der Veröffentlichung: 2015

Seiten: 684-692

Zeitschrift: European Journal of Preventive Cardiology

Bandnummer: 22

Heftnummer: 6

ISSN: 2047-4873

eISSN: 2047-4881

Open Access Status: Bronze

DOI Link: https://doi.org/10.1177/2047487314529691

Verlag: Oxford University Press

Abstract: 
Background:The average diagnostic sensitivity of exercise stress tests (ESTs) is lower than that of other non-invasive cardiac stress tests. The aim of the study was to examine whether high-sensitivity cardiac troponin T (hs-cTnT) or copeptin concentrations rise in response to inducible myocardial ischaemia and may improve the diagnostic accuracy of ESTs. Methods and results:An EST was performed stepwise on a bicycle ergometer by 383 consecutive patients with suspected or progression of coronary artery disease (CAD). In addition venous blood samples for measurement of hs-cTnT and copeptin were collected prior to EST, at peak exercise, and 4h after EST. Coronary angiography was assessed for all patients. Patients with significant CAD (n=224) were more likely to be male and older compared to patients with non-significant CAD (n=169). Positive EST was documented in 125 (55.8%) patients with significant CAD and in 69 (43.4%) patients with non-significant CAD. Copeptin and hs-cTnT concentrations at baseline were higher in patients with significant CAD (copeptin: 10.8pmol/l (interquartile range (IQR) 8.1-15.6) vs 9.4pmol/l (IQR 7.1-13.9); p=0.04; hs-cTnT: 3.0ng/l (IQR <3.0-5.4) vs <3.0ng/l (IQR <3.0); p=0.006). Hs-cTnT improved sensitivity (61.6% vs 55.8%), specificity (67.7% vs 56.6%) and the positive predictive value (PPV) (72.3% vs 64.4%) and negative (55.2% vs 47.6%) predictive value (NPV) of EST. Copeptin could not improve sensitivity (55.4% vs 55.8%) and reduced specificity, PPV and NPV. Conclusions:The measurement of hs-cTnT during EST improves sensitivity, specificity, and positive and negative predictive values. In contrast, measurement of copeptin does not improve diagnostic sensitivity and reduces specificity.

Harvard-Zitierstil: Liebetrau, C., Gaede, L., Doerr, O., Hoffmann, J., Wolter, J., Weber, M., et al. (2015) High-sensitivity cardiac troponin T and copeptin assays to improve diagnostic accuracy of exercise stress test in patients with suspected coronary artery disease, European Journal of Preventive Cardiology, 22(6), pp. 684-692. https://doi.org/10.1177/2047487314529691

APA-Zitierstil: Liebetrau, C., Gaede, L., Doerr, O., Hoffmann, J., Wolter, J., Weber, M., Rolf, A., Hamm, C., Nef, H., & Moellmann, H. (2015). High-sensitivity cardiac troponin T and copeptin assays to improve diagnostic accuracy of exercise stress test in patients with suspected coronary artery disease. European Journal of Preventive Cardiology. 22(6), 684-692. https://doi.org/10.1177/2047487314529691