title: Cardiac biomarkers in systemic sclerosis: contribution of high-sensitivity cardiac troponin in addition to N-terminal pro-brain natriuretic peptide.
abstract: OBJECTIVE
  To measure plasma concentrations of high-sensitivity cardiac troponin T (HS-cTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with systemic sclerosis (SSc; scleroderma) and age- and sex-matched healthy control subjects, and to examine the contribution of traditional cardiovascular risk factors and SSc features to the concentrations of these 2 cardiac biomarkers.
  
  
  METHODS
  Plasma HS-cTnT and NT-proBNP concentrations were measured using the electrochemiluminescence method and sandwich immunoassay, respectively.
  
  
  RESULTS
  The study group comprised 161 unrelated patients with SSc and 213 matched control subjects. HS-cTnT and NT-proBNP plasma levels were significantly increased in SSc patients compared with controls (both P < 0.001). Similar results were observed in the subgroup of patients with SSc who had no cardiovascular risk factors (n = 72). Multivariate logistic regression analysis confirmed diabetes mellitus (P = 0.006), high blood pressure (P = 0.021), precapillary pulmonary hypertension (P = 0.039), and the diffuse cutaneous SSc (P = 0.004) as factors independently associated with an HS-cTnT level of >14 ng/liter. Increased NT-proBNP concentrations were associated only with the presence of precapillary pulmonary hypertension (P < 0.001). Normal concentrations of both HS-cTnT and NT-proBNP had a high negative predictive value for precapillary pulmonary hypertension (92%), and the combination of increased values of these 2 markers had the highest strength of association with precapillary pulmonary hypertension in logistic regression analysis.
  
  
  CONCLUSIONS
  HS-cTnT and NT-proBNP concentrations are increased in patients with SSc, even in those who are free of cardiovascular risk factors. These easily obtained biomarkers may be useful for systematic evaluation and stratification of SSc patients, especially to identify those at risk of pulmonary hypertension.
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité, Cochin Hospital, and Paris Descartes University, INSERM U1016 and CNRS UMR8104, Cochin Institute, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Avouac
authors.affiliation: Paris 13 University, University Hospital of Paris-Seine-Saint-Denis, Bobigny, France and UMR 942, Paris, France.
authors.forename: Christophe
authors.initials: C
authors.lastname: Meune
authors.affiliation: Cochin and Hôtel-Dieu Hospitals, Paris, France.
authors.forename: Camille
authors.initials: C
authors.lastname: Chenevier-Gobeaux
authors.affiliation: Cochin and Hôtel-Dieu Hospitals, Paris, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Borderie
authors.affiliation: Tenon Hospital, Paris, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Lefevre
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité, Cochin Hospital, Paris, France.
authors.forename: André
authors.initials: A
authors.lastname: Kahan
authors.affiliation: Paris Descartes University, Sorbonne Paris Cité, Cochin Hospital, and Paris Descartes University, INSERM U1016 and CNRS UMR8104, Cochin Institute, Paris, France.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D020107:Troponin T / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D020107:Troponin T; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain