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Article Dans Une Revue Journal of Clinical Medicine Année : 2020

Value of Cardiac Biomarkers in the Early Diagnosis of Takotsubo Syndrome

Lucie Thebaud
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Stéphane Greciano
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Nicolas Meyer
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Laurence Jesel
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Patrick Ohlmann
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Olivier Morel
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Résumé

BACKGROUND: Bedside diagnosis between Takotsubo syndrome (TTS) and ST elevation (STEMI) and non-ST elevation (NSTEMI) myocardial infarction remains challenging. We sought to determine a cardiac biomarker profile to enable their early distinction. METHODS: 1100 patients (TTS n = 314, STEMI n = 452, NSTEMI n = 334) were enrolled in two centers. Baseline clinical and biological characteristics were compared between groups. RESULTS: At admission, cut-off values of BNP (B-type natriuretic peptide)/TnI (Troponin I) ratio of 54 and 329 distinguished respectively STEMI from NSTEMI, and NSTEMI from TTS. Best differentiation was obtained by the use of BNP/TnI ratio at peak (cut-of values of 6 and 115 discriminated respectively STEMI from NSTEMI, and NSTEMI from TTS). We developed a score including five parameters (age, gender, history of psychiatric disorders, LVEF, and BNP/TnI ratio at admission) enabling good distinction between TTS and STEMI (77% specificity and 92% sensitivity, AUC 0.93). For the distinction between TTS and NSTEMI, a four variables score (gender, history of psychiatric disorders, LVEF, and BNP at admission) achieved a good diagnostic performance (89% sensitivity, 85% specificity, AUC 0.94). CONCLUSION: A distinctive cardiac biomarker profile enables at an early stage a differentiation between TTS and ACS. A four (NSTEMI) or five variables score (STEMI) permitted a better discrimination.
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Dates et versions

hal-03603578 , version 1 (09-12-2022)

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Charlotte Dagrenat, Jean-Jacques von Hunolstein, Kensuke Matsushita, Lucie Thebaud, Stéphane Greciano, et al.. Value of Cardiac Biomarkers in the Early Diagnosis of Takotsubo Syndrome. Journal of Clinical Medicine, 2020, 9 (9), pp.2985. ⟨10.3390/jcm9092985⟩. ⟨hal-03603578⟩
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