title: Simple markers can distinguish Takotsubo cardiomyopathy from ST segment elevation myocardial infarction.
abstract: BACKGROUND
  Takotsubo cardiomyopathy (TTC) is a clinical condition mimicking acute myocardial infarction. A specific biomarker for TTC screening is required, but until now, no single biomarker has been established for the early diagnosis of TTC and differentiation from ST-segment elevation myocardial infarction (STEMI). In our study we focused on the simple markers that are available in every hospital.
  
  
  METHODS
  In 66 consecutive patients (pts) who were hospitalized with TTC and 66 pts with STEMI, cardiac biomarkers, such as NT-proBNP, TnI, CK and CKMB mass were determined during 12h from admission and compared with demographic, clinical and echocardiographic findings.
  
  
  RESULTS
  The concentration of NTproBNP was greater in pts with TTC than STEMI (4702pg/ml vs 2138pg/ml). The concentration of TnI and CKMB mass was greater in the STEMI group than in the TTC group (TnI: 2.1ng/ml and CK MB mass: 9.5ng/ml in pts with TTC vs TnI: 19ng/ml and CK MB mass: 73.3ng/ml in pts with STEMI). The NTproBNP/TnI ratio and NTproBNP/CKMB mass ratio were, respectively, 2235.2 and 678.2 in pts with TTC and 81.6 and 27.5 in pts with STEMI (p<0.001). Moreover, the NTproBNP/EF ratio was also statistically significant (110.4 in TTC group and 39.4 in STEMI group).
  
  
  CONCLUSIONS
  NTproBNP/TnI, NTproBNP/CKMB mass and NTproBNP/EF ratios can distinguish TTC from STEMI at an early stadium. The most accurate marker is the NTproBNP/TnI ratio.
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland. Electronic address: moni.budnik@gmail.com.pl.
authors.forename: Monika
authors.initials: M
authors.lastname: Budnik
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Janusz
authors.initials: J
authors.lastname: Kochanowski
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Radoslaw
authors.initials: R
authors.lastname: Piatkowski
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Karolina
authors.initials: K
authors.lastname: Wojtera
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Michal
authors.initials: M
authors.lastname: Peller
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Gaska
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Paulina
authors.initials: P
authors.lastname: Glowacka
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Paulina
authors.initials: P
authors.lastname: Karolczak
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Ochijewicz
authors.affiliation: 1st Department of Cardiology, Medical University of Warsaw, 1a Banacha Street, 02-097 Warsaw, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Opolski
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D054549:Takotsubo Cardiomyopathy / Q000097:blood* / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Cardiac biomarkers; Differential diagnosis; Takotsubo cardiomyopathy