TnT based diagnosis of paroxysmal atrial fibrillation

一种心房纤颤、阵发性的技术，应用在疾病诊断、材料检验品、测量装置等方向，能够解决阵发性心房纤颤难诊断等问题

Active Publication Date: 2018-06-05
F HOFFMANN LA ROCHE & CO AG
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

While these numbers relate to persistent atrial fibrillation, paroxysmal atrial fibrillation is even more difficult to diagnose and can only be captured by inpatient cardiac telemetry or even Holter monitoring

Method used

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  • TnT based diagnosis of paroxysmal atrial fibrillation

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0239] Example 1: Patient Cohorts

[0240] TnT-hs, IL-6, NT-proBNP and hsCRP levels have been determined in plasma samples of n=46 patients in sinus rhythm (SR) blood sampling and biomarker determination at the 12-month visit. All patients had >= 1 recurrence of atrial fibrillation from randomization to the 12-month visit. All 46 patients converted to sinus rhythm spontaneously.

[0241] • 0-7 days after paroxysmal atrial fibrillation (AF); n=9 patients

[0242] • 8-30 days after paroxysmal AF; n=10 patients.

Embodiment 2

[0243] Example 2: Determination

[0244] Troponin T was determined using Roche's electrochemiluminescent ELISA sandwich test Elecsys Troponin Ths (High Sensitivity) STAT (Short Turn Around Time) assay. The test employs two monoclonal antibodies specific for human cardiac troponin T. The antibody recognizes two epitopes (amino acid positions 125-131 and 136-147) located in the central portion of the cardiac troponin T protein, which consists of 288 amino acids. The hs-TnT assay allows measurement of troponin T levels in the range of 3 to 10000 pg / mL.

[0245] NT-proBNP was determined using Roche's electrochemiluminescence ELISA sandwich test Elecsys proBNP II STAT (short turnaround time) assay. The test employs two monoclonal antibodies that recognize epitopes located in the N-terminal portion (1-76) of pro-BNP(1-108).

[0246] IL-6 (Interleukin 6) was measured by electrochemiluminescence immunoassay (ECLIA, Roche Diagnostics). Testing was performed using a Cobas E601 analy...

Embodiment 3

[0248] Example 3: Results

[0249] The results are shown in the table below.

[0250] Days after paroxysmal atrial fibrillation

hsTnT (pg / mL)

Nt-proBNP

hsCRP mg / l

IL-6 pg / ml

0-7 (n= 6)

8.37

191

4.20

2.21

8-30 (n=10)

6.51

58

4.35

2.04

[0251] Data evaluation showed that TnT-hs levels (independent of other biomarkers) above reference values ​​(in this study > 6 pg / mL ) are suspected to have paroxysmal atrial fibrillation and may benefit from anticoagulation. It has even been shown that TnT-hs levels can be detected in patients presenting sinus rhythm after 7-30 days. Other markers such as hsCRP show somewhat different kinetics following spontaneous termination of atrial fibrillation, and thus may, alone and / or in combination, aid in the detection of past episodes of paroxysmal atrial fibrillation.

[0252] Therefore, recent diagnosis of paroxysmal atrial fibrillation in patients presenting sinus rhythm within...

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Abstract

The present invention relates to a method for diagnosing a recent paroxysmal atrial fibrillation. The method is based on the determination of the at least one marker selected from the group consistingof a cardiac Troponin, NT-proBNP (N-terminal prohormone of brain natriuretic peptide), hsCRP, IL-6 (Interleukin-6) and IGFBP7 (Insulin like growth factor binding protein 7) in a sample from the subject, and on the comparison of the, thus, determined amount(s) with a reference amount (reference amounts). Further, the present invention relates to a method for identifying a subject being susceptibleto anticoagulation therapy. Further envisaged are systems, reagents and kits used in performing the methods disclosed herein.

Description

[0001] This application is a divisional application of the following applications: filing date: November 11, 2013; application number: 201380058506.1 (PCT / EP2013 / 073476); title of invention: same as above. technical field [0002] The present invention relates to methods for diagnosing recent paroxysmal atrial fibrillation. The method is based on the determination of cardiac troponin, NT-proBNP (N-terminal prohormone of brain natriuretic peptide), hsCRP, IL-6 (interleukin-6) and IGFBP7 (insulin-like growth hormone) in a sample from a subject. At least one marker of a factor binding protein 7) and comparing the thus determined amount(s) with a reference amount(s). Further, the present invention relates to methods for identifying subjects susceptible to anticoagulant therapy and methods for diagnosing progressive atrial fibrillation based on the determination of the amount of IGFBP7. Systems, reagents, and kits for performing the methods disclosed herein are further contempla...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): G01N33/68
CPCG01N33/68G01N33/6887G01N2333/4737G01N2333/5412G01N2333/58G01N33/6893G01N33/74G01N33/6869G01N2333/4712G01N2333/4745G01N2800/326G01N2800/52
Inventor D.布洛克R.拉蒂尼S.马松U-H.温许斯-特伦C.曹格A.齐格勒
Owner F HOFFMANN LA ROCHE & CO AG
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