DIAGNOSIS AND RISK STRATIFICATION USING NT-proET-1

Abstract

The invention relates to a method for the diagnosis and/or risk stratification of cardiac diseases and diseases of the respiratory tract and lungs. According to said method, the free fragment N-terminal proEndothelin (NT-proET-1; amino acids 18-52 of the preproET according to FIG. 1 ) or fragments and partial peptides thereof is or are determined.

1 . A method for the in-vitro diagnosis and/or risk stratification of heart diseases and/or diseases of the lungs and respiratory tract, determining the free fragment NT-proET-1 (18-52), or fragments and partial peptides thereof, in a patient to be examined. 
     
     
         2 . The method for the diagnosis and/or risk stratification of heart diseases according to  claim 1 , characterized in that the heart diseases are selected from acute coronary syndrome, post-myocardial infarction, and cardiac insufficiency. 
     
     
         3 . The method for the diagnosis and/or risk stratification of diseases of the lungs and respiratory tract according to  claim 1 , characterized in that they are selected from infections cause by bacteria, viruses, fungi or parasites, particularly lower respiratory tract infections (LRTI), bronchitis, pneumonia, sarcoidosis, bronchiectases, noncardiac pulmonary edema and/or chronic diseases of the lungs and respiratory tract, particularly interstitial lung diseases and pulmonary fibrosis, chronic obstructive pulmonary disease (COPD), particularly COPD infection exacerbations, bronchial asthma, particularly infection exacerbations with bronchial asthma. 
     
     
         4 . A method for the diagnosis and/or risk stratification according to  claim 1 , for the identification of patients that are at increased risk and/or have an unfavorable prognosis for heart diseases and/or diseases of the lungs and respiratory tract. 
     
     
         5 . A method for the diagnosis and/or risk stratification according  claim 1  , wherein the patient is a symptomatic and/or asymptomatic patient, particularly an emergency patient. 
     
     
         6 . A method for the diagnosis and/or risk stratification according to  claim 1  , for the control of the therapy of heart diseases and/or diseases of the lungs and respiratory tract, particularly in intensive care or emergency care. 
     
     
         7 . A method for the diagnosis and/or risk stratification of heart diseases and/or diseases of the lungs and respiratory tract according to  claim 1 , for the execution of clinical decisions, particularly advanced treatments and therapies using drugs, particularly in intensive care or emergency care, to include the decision to hospitalize the patient. 
     
     
         8 . A method for the diagnosis and/or risk stratification of heart diseases and/or diseases of the lungs and respiratory tract according to  claim 1 , for the prognosis, early detection and detection by differential diagnosis, assessment of the severity, and assessment of the course of the disease concomitant with the therapy. 
     
     
         9 . A method according to  claim 1 , characterized in that additionally a determination of at least one further marker is carried out, selected from the group of inflammatory markers, cardiovascular markers, neurohormonal markers, or ischemic markers. 
     
     
         10 . A method according to  claim 9 , characterized in that the inflammatory marker is selected from at least one marker of the group of C-reactive protein (CRP), cytokines such as TNF-alpha, interleukines such as IL-6, procalcitonin (1-116, 3-116), and adhesion molecules such as VCAM or ICAM. 
     
     
         11 . A method according to  claim 9 , characterized in that the cardiovascular marker is selected from at least one marker of the group creatine kinase, myoglobin, myeloperoxidase, natriuretic protein, particularly ANP (or ANF), proANP, NT-proANP, BNP, proBNP, NT-proBNP, or a partial sequence thereof, cardiac troponin, CRP, and also regulatory (pro)hormones, such as pro-gastrin releasing peptide (pro-GRP), pro-endothelin-2, pro-endothelin-3, pro-leptin, pro-neuropeptide Y, pro-somatostatin, pro-neuropeptide YY, pro-opionmelanocortin, pro-adrenomedullin (pro-ADM), pro-vasopressin (pro-AVP), or a partial sequence thereof. 
     
     
         12 . A method according  claim 9 , characterized in that the ischemic marker is selected from at least one marker of the group troponin I and T, CK-MK. 
     
     
         13 . A method according to  claim 9 , characterized in that the neurohormonal marker is at least one natriuretic protein, particularly ANP (or ANF), proANP, NT-proANP, BNP, proBNP, NT-proBNP, or a partial sequence thereof. 
     
     
         14 . A method according to  claim 9 , characterized in that parallel or simultaneous determinations of the markers are carried out. 
     
     
         15 . A method according to  claim 1 , characterized in that the determinations are carried out using at least one patient sample 
     
     
         16 . A method according to  claim 1 , characterized in that the determinations are carried out using an automatic analysis system, particularly by means of a Kryptor. 
     
     
         17 . A method according to  claim 1 , characterized in that the determinations are carried out using a rapid test, particularly in individual or multiple parameter determinations. 
     
     
         18 . Use of the free fragment NT-proET-1, or fragments and partial peptides thereof, for the diagnosis and/or risk stratification of heart diseases and/or diseases of the lungs and respiratory tract, and optionally further markers, according to  claim 9 . 
     
     
         19 . A kit for the diagnosis and/or risk stratification of heart diseases and/or diseases of the lungs and respiratory tract, comprising detection reagents for the determination of the free fragment NT-proET-1, or fragments and partial peptides thereof, and optionally further markers, according to  claim 9  and auxiliary agents. 
     
     
         20 . A diagnostic device for carrying out a method according to  claim 1 .