title: The diagnostic significance of NT-proBNP and troponin I in emergency department patients presenting with palpitations.
abstract: OBJECTIVE
  This prospective study investigated the diagnostic significance of the N-terminal pro-brain natriuretic (NT-proBNP) and troponin I peptides in emergency department patients presenting with palpitations.
  
  
  METHODS
  Two groups of patients with palpitations but without documented supraventricular tachycardia were compared: a group with supraventricular tachycardia (n = 49) and a control group (n = 47). Both groups were diagnosed using electrophysiological studies during the study period. Blood samples were obtained from all of the patients to determine the NT-proBNP and troponin I levels within the first hour following arrival in the emergency department.
  
  
  RESULTS
  The mean NT-proBNP levels were 207.74±197.11 in supraventricular tachyarrhythmia group and 39.99±32.83 pg/mL in control group (p<0.001). To predict supraventricular tachycardia, the optimum NT-proBNP threshold was 61.15 pg/mL, as defined by the receiver operating characteristic (ROC) curve, with a non-significant area under the ROC curve of 0.920 (95% CI, 0.86-0.97, p<0.001). The NT-proBNP cut-off for diagnosing supraventricular tachycardia had 81.6% sensitivity and 91.5% specificity. Supraventricular tachycardia was significantly more frequent in the patients with NT-proBNP levels ≥61.15 pg/mL (n = 44, 90.9%, p>0.001). The mean troponin I levels were 0.17±0.56 and 0.01±0.06 pg/mL for the patients with and without supraventricular tachycardia, respectively (p<0.05). Of the 96 patients, 21 (21.87%) had troponin I levels ≥0.01: 2 (4.25%) in the control group and 19 (38.77%) in the supraventricular tachycardia group (p<0.001).
  
  
  CONCLUSIONS
  Troponin I and, in particular, NT-proBNP peptide were helpful for differentiating supraventricular tachycardia from non- supraventricular tachycardia palpitations. Further randomized, large, multicenter trials are needed to define the benefit and diagnostic role of NT-proBNP and troponin I in the management algorithm of patients presenting with palpitations in emergency departments.
authors.affiliation: Abant Izzet Baysal University chool of Medicine, Department of Emergency Medicine, Bolu, Turkey.
authors.forename: Tarık
authors.initials: T
authors.lastname: Ocak
authors.forename: Alim
authors.initials: A
authors.lastname: Erdem
authors.forename: Arif
authors.initials: A
authors.lastname: Duran
authors.forename: Ümit Yaşar
authors.initials: ÜY
authors.lastname: Tekelioğlu
authors.forename: Serkan
authors.initials: S
authors.lastname: Öztürk
authors.forename: Suzi Selim
authors.initials: SS
authors.lastname: Ayhan
authors.forename: Mehmet Fatih
authors.initials: MF
authors.lastname: Özlü
authors.forename: Mehmet
authors.initials: M
authors.lastname: Tosun
authors.forename: Hasan
authors.initials: H
authors.lastname: Koçoğlu
authors.forename: Mehmet
authors.initials: M
authors.lastname: Yazıcı
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D013617:Tachycardia, Supraventricular / Q000097:blood* / Q000175:diagnosis; D019210:Troponin I / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain