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Significance of Screening the General Population for Potential Cardiovascular Diseases with a Combination Assay of B-type Natriuretic Peptide and High Sensitive Troponin I

Sugawa S

Objectives: With increasing number of deaths by cardiovascular diseases, to develop an efficient method to screen the general population, such as a screening using biomarkers, for potential cardiovascular diseases is essential. We assessed the effectiveness of a combination assay of B-type natriuretic peptide (BNP) and cardiac troponin I (TnI) in detecting individuals with high cardiovascular risks.

Methods: BNP and TnI were determined using Abbott Architect immunoassays in 950 subjects who visited Takeda Hospital Medical Examination Center for the annual health check.

Results: The BNP level and TnI level were independently and positively associated with the Framingham Risk Score (FRS). The presence of hypertension, and CKD were positively, but that of dyslipidemia was negatively associated with the BNP level, while the presence of hypertension and dyslipidemia were positively associated with the TnI level. In a BNP-TnI plot where BNP is in the X-axis and TnI was in the Y-axis, we categorized the subjects into quadrants with the BNP cut-off (40.0 pg/ml) and the TnI cut-off (26.2 pg/ml); quadrant A (upper left), quadrant B (lower left), quadrant C (lower right) and quadrant D (upper right). In quadrants A, B, C and D, the number of subjects were 9, 932, 9 and 0, respectively. By assessing the differences between pairs of quadrants among quadrant A, B and C in terms of age, body mass index (BMI), systolic blood pressure (SBP), heart rate (HR), cardiothoracic ratio (CTR), vital capacity (VC), haemoglobin (Hb), platelet count (PLT), uric acid (UA), estimated glomerular filtration rate (eGFR), blood urea nitrogen (BUN), low-density lipoprotein cholesterol (LDL-C), highdensity lipoprotein cholesterol (HDL-C), triglyceride (TG), hemoglobin A1c (HbA1c) and fasting blood glucose (FBG) and the FRS, BMI, CTR and the FRS were higher in quadrants A than quadrant B while age, CTR, PLT and the FRS were higher in quadrants C than quadrant B. The factors that differentiated quadrants A and C were age, BMI and TG.

Conclusion: We conclude that not only BNP but also TnI could provide important information for cardiovascular risks in the general population due to its ability to detect the different high risk population as BNP could detect.