Clinical chemistry
-
Comparative Study
Comparison of midregional pro-A-type natriuretic peptide and the N-terminal pro-B-type natriuretic peptide for predicting mortality and cardiovascular events.
N-terminal pro-B-type natriuretic peptide (NT-proBNP) provides prognostic information on mortality and future cardiovascular events for individuals from the general population. A novel immunoassay was recently developed that measures a midregional fragment of pro-A-type natriuretic peptide (MR-proANP). We compared the capabilities of MR-proANP and NT-proBNP for predicting mortality and cardiovascular events in a population-based study. ⋯ MR-proANP was as efficient as NT-proBNP in predicting all-cause mortality, cardiovascular mortality, and cardiovascular events; however, its association with cardiovascular mortality was not independent from other confounders.
-
Although myeloperoxidase (MPO) monitoring is predictive for cardiovascular outcomes in suspected acute coronary syndromes, the value of serial testing is unknown. ⋯ MPO concentrations are predictive of outcome up to 16 h after presentation with chest pain and predict events missed by cTnI testing, supporting a potential role in rapid patient triage.
-
Prostate cancer is the most commonly diagnosed cancer among men in North America and is a leading cause of death. Standard treatments include androgen deprivation therapy, which leads to improved clinical outcomes. However, over time, most tumors become androgen independent and no longer respond to hormonal therapies. Several mechanisms have been implicated in the progression of prostate cancer to androgen independence. ⋯ Understanding of the molecular mechanisms that lead to the development of androgen-independent prostate cancer will allow for improved therapeutic strategies that target key pathways and molecules that are essential for these cells to survive.
-
Two recent clinical trials showed that adding copeptin to a conventional cardiac troponin assay improved diagnostic performance for patients with chest pain early after symptom onset. We prospectively tested whether copeptin adds information to that provided by a high-sensitivity cardiac troponin T (hscTnT) assay in the early evaluation of patients with suspected acute myocardial infarction, particularly non-ST-segment elevation myocardial infarction (non-STEMI). ⋯ A strategy using copeptin with hscTnT at prespecified cutoffs improves the ruling out of non-STEMI, compared with using hscTnT alone; thus, this strategy could help to obviate a prolonged stay in the emergency department.
-
Editorial Comment
Point-of-care testing quality: some positives but also some negatives.