Significance of Screening the General Population for Potential Cardiovascular Diseases with a Combination Assay of B-type Natriuretic Peptide and High Sensitive Troponin I
2017
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.
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