Abstract 19143: Role of Cardiac Biomarkers in Diagnosing Takotsubo Cardiomyopathy from Left Anterior Descending Artery ST Elevation Myocardial Infarction
Introduction: Takostubo cardiomyopathy (TK) and STEMI in the proximal to mid LAD territory (LAD-S) may have similar clinical, ECG and echocardiographic presentation. The two can only be differentiated using coronary angiography.
Hypothesis: We hypothesized that the ratio of serum BNP to troponin-I(TnI) will help in distinguishing TK from LAD-S. Previously it has been studied in TK and STEMI from any coronary artery lesion. This is the first study to tease out LAD-S and TK by using BNP/TnI ratio .
Methods: We retrospectively compared patients who presented with LAD-S and patients with TK (confirmed with non-obstructive coronary angiography, classic echocardiographic appearance and subsequent improvement of LV function). Patients who did not have BNP and TnI available were excluded.
Results: Out of 313 patients with LAD-S and 464 with possible TK, 39 and 62 patients were included respectively. Mean BNP and TnI levels were 788, 57.6ng/dl and 923, 3.4ng/dl in LAD-S and TK respectively. A BNP/TnI ratio of ≤6.4 was 100% sensitive and 41% specific to diagnose LAD-S, and therefore has 100% negative predictive value. A BNP/TnI ratio of ≥2388 was 80% sensitive and 93% specific for diagnosing TK.
Conclusion: BNP/TnI ratio <6.4 is reliable to rule out TK and lead to the diagnosis of LAD-S in patients with typical echocardiographic findings. Further, larger observational studies are needed to validate the use of biomarkers for this purpose.
Author Disclosures: G. Akbar: None. M. Badri: None. C. Prince: None. W. Saeed: None. G. Mirrani: None. M. Ameen: None. A.Y. Soomro: None. T. Shapiro: None. M.R. Sardar: None.
- © 2014 by American Heart Association, Inc.