Journal
SCANDINAVIAN JOURNAL OF CLINICAL & LABORATORY INVESTIGATION
Volume 75, Issue 3, Pages 204-212Publisher
TAYLOR & FRANCIS LTD
DOI: 10.3109/00365513.2014.993694
Keywords
Angina pectoris; atherosclerosis; biological markers; troponin; exercise test
Categories
Funding
- Danish Heart Foundation [07-10-R61-A1807-B859-22396F]
- Th. Maigaards Eftf. Fru Lily Benthine Lunds Fond
- Direktoer Kurt Boennelycke og hustru Fru Grethe Boennelyckes Fond
- Fru Gudrun Elboth mindelegat
- Jens Anker Andersen Fonden
- Henry og Astrid Moellers Fond
- Grosserer Chr. Andersen og hustru Ingeborg Ovidia Signe Andersen Legat, Beckett Fonden
- Snedkermester Sophus Jacobsen og hustru Astrid Jacobsens Fond
- Krista og Viggo Petersens Fond
- Alfred Helsteds og Eli Moellers legat, Murermester Laurits Peter Christensen og hustru Kirsten Sigrid Christensens Fond
- Arvid Nielssons Fond
- Else og Mogens Wedell-Wedellsborg Fond
- Axel Muusfeldts Fond
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Background. We tested the effects of exercise intensity, sampling intervals, degree of coronary artery stenosis, and demographic factors on circulating N-terminal pro B-Type natriuretic peptide (NT-pro-BNP) and cardiac Troponin T (cTnT) in subjects suspected of coronary artery disease (CAD). Materials and methods. A total of 242 subjects referred for diagnostic evaluation of possible CAD had blood samples obtained before, 5 min after, and again 20 h after a symptom-limited exercise test. Results. Totally 40 subjects had CAD with >50% stenosis, 115 subjects had no stenosis and 87 subjects served as controls. In univariate analysis CAD-subjects had higher median baseline NT-pro-BNP-levels (85.3 ng/L) compared with non-CAD-subjects (41.3 ng/L) and controls (40.1 ng/L), both p < 0.001, but the association disappeared in multivariate analysis adjusted for age and gender. NT-pro-BNP increased similarly after exercise in CAD-subjects, non-CAD-subjects, and controls (median increase 8.14 ng/L) and the increase was positively associated with baseline NT-pro-BNP but not presence of CAD. Median baseline cTnT was 6.25 ng/L in CAD-subjects and 3.00 ng/L in non-CAD-subjects as well as controls, both p < 0.0001. Median Delta cTnT (baseline to 20 h after exercise) was higher in CAD-subjects than non-CAD-subjects and controls (0.62 ng/L vs. 0.0 ng/L, p < 0.001). A linear relationship between Delta cTnT and 'percent of predicted maximal heart rate achieved' was found in subjects with >= 70% stenosis (n = 24, r = 0.4067 p = 0.046). Conclusions. Baseline cTnT and Delta cTnT were found to be independently associated with CAD and also with exercise intensity in stable chest pain subjects. These properties were not identified for NT-pro-BNP.
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