The role of peak NT-proBNP/peak cardiac troponin T ratio obtained within 3 days of admission to discriminate Takotsubo from acute coronary syndrome

Abstract Background Takotsubo syndrome (TS) is not usually diagnosed until a patient with suspected acute coronary (ACS) found to have no hemodynamically significant lesions on angiography (CA). Purpose We explored whether cardiac biomarker profile can contribute early diagnosis of TS, which could be useful when CA either available or does provide definitive diagnosis. Methods Ratios N-terminal-pro brain natriuretic peptide (NT-proBNP) and troponin T (cTnT) [admission peak levels the two consecutive days following admission, expressed in pg/mL] were compared 41 patients TS 50 ACS patients. Results Both admission NT-proBNP/cTnT ratio NT-proBNP/peak cTnT higher those (38.8±57.1 vs 15.2±33.1, p=0.038 29.1±26.2 2.2±3.9, p<0.001, respectively). Only association remained statistically after adjustment for age gender multiple linear regression analysis was used (R square=0.746, p<0.001). ROC curve discriminated as opposed (AUC=0.921 95% CI: 0.851–0.990, A cut-off value >5.5 had sensitivity 85%, specificity 90% an accuracy 88.1% detecting ACS. Conclusions Peak obtained within first 3 has good diagnostic identify among presenting This discrimination between entities easily available, particularly without ST-segment elevation low intermediate-risk. Funding Acknowledgement Type funding sources: None.