Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia
Mei Yang,1 Aili Xuan,1 Guoji Zhu2 1Department of Pediatrics, First Affiliated Hospital of Bengbu Medical University, Anhui, People’s Republic of China; 2Department of Infectious Diseases, Children’s Hospital, Soochow University, Jiangsu, People’s Republic of ChinaCorrespondence: Guoji Zhu, Email zut...
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Dove Medical Press
2025-06-01
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| author | Yang M Xuan A Zhu G |
| author_facet | Yang M Xuan A Zhu G |
| author_sort | Yang M |
| collection | DOAJ |
| description | Mei Yang,1 Aili Xuan,1 Guoji Zhu2 1Department of Pediatrics, First Affiliated Hospital of Bengbu Medical University, Anhui, People’s Republic of China; 2Department of Infectious Diseases, Children’s Hospital, Soochow University, Jiangsu, People’s Republic of ChinaCorrespondence: Guoji Zhu, Email zutt681@163.comObjective: To evaluate the diagnostic performance of combined N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) testing for myocardial injury in children with Mycoplasma pneumoniae pneumonia (MPP).Methods: This retrospective study included 103 pediatric patients with MPP complicated by myocardial injury admitted between December 2021 and December 2023. Patients were stratified by New York Heart Association (NYHA) functional class (I–IV). Demographic and clinical characteristics, biomarker levels, and diagnostic accuracy were analyzed. ROC curves were used to assess diagnostic performance of single and combined biomarkers.Results: No significant differences were observed in age or gender across NYHA classes. However, BMI Z-scores declined significantly with worsening class (P = 0.013), while heart rate, systolic blood pressure, fever duration, respiratory rate, and hospital stay increased progressively (all P < 0.01), indicating disease severity. Serum NT-proBNP and cTnI levels rose in parallel with advancing NYHA class (P < 0.001 between all adjacent groups). A strong positive correlation was found between NT-proBNP and cTnI (r = 0.617, P < 0.001). Combined biomarker testing demonstrated superior diagnostic accuracy (AUC = 0.914), outperforming NT-proBNP (AUC = 0.877) and cTnI alone (AUC = 0.739). The combination improved sensitivity (94.15%) and specificity (95.19%), reducing false negatives and enhancing risk stratification. Notably, 80% of NYHA class III–IV cases were correctly reclassified into the high-risk group, with a net reclassification improvement (NRI) of +34.2% (P = 0.002).Conclusion: Combined NT-proBNP and cTnI testing provides robust diagnostic efficacy for myocardial injury in pediatric MPP. This dual-biomarker strategy enables earlier identification of high-risk patients and supports more precise clinical management.Keywords: NT-proBNP, cTnI, combined testing, children, mycoplasma pneumoniae pneumonia, myocardial injury, diagnostic efficacy, ROC |
| format | Article |
| id | doaj-art-06efdff96af34d1f8f428d815a1febbd |
| institution | DOAJ |
| issn | 1178-2390 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | Dove Medical Press |
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| series | Journal of Multidisciplinary Healthcare |
| spelling | doaj-art-06efdff96af34d1f8f428d815a1febbd2025-08-20T03:24:01ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902025-06-01Volume 18Issue 137093716104233Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae PneumoniaYang M0Xuan AZhu G1Department of PediatricsDepartment of Infectious DiseasesMei Yang,1 Aili Xuan,1 Guoji Zhu2 1Department of Pediatrics, First Affiliated Hospital of Bengbu Medical University, Anhui, People’s Republic of China; 2Department of Infectious Diseases, Children’s Hospital, Soochow University, Jiangsu, People’s Republic of ChinaCorrespondence: Guoji Zhu, Email zutt681@163.comObjective: To evaluate the diagnostic performance of combined N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) testing for myocardial injury in children with Mycoplasma pneumoniae pneumonia (MPP).Methods: This retrospective study included 103 pediatric patients with MPP complicated by myocardial injury admitted between December 2021 and December 2023. Patients were stratified by New York Heart Association (NYHA) functional class (I–IV). Demographic and clinical characteristics, biomarker levels, and diagnostic accuracy were analyzed. ROC curves were used to assess diagnostic performance of single and combined biomarkers.Results: No significant differences were observed in age or gender across NYHA classes. However, BMI Z-scores declined significantly with worsening class (P = 0.013), while heart rate, systolic blood pressure, fever duration, respiratory rate, and hospital stay increased progressively (all P < 0.01), indicating disease severity. Serum NT-proBNP and cTnI levels rose in parallel with advancing NYHA class (P < 0.001 between all adjacent groups). A strong positive correlation was found between NT-proBNP and cTnI (r = 0.617, P < 0.001). Combined biomarker testing demonstrated superior diagnostic accuracy (AUC = 0.914), outperforming NT-proBNP (AUC = 0.877) and cTnI alone (AUC = 0.739). The combination improved sensitivity (94.15%) and specificity (95.19%), reducing false negatives and enhancing risk stratification. Notably, 80% of NYHA class III–IV cases were correctly reclassified into the high-risk group, with a net reclassification improvement (NRI) of +34.2% (P = 0.002).Conclusion: Combined NT-proBNP and cTnI testing provides robust diagnostic efficacy for myocardial injury in pediatric MPP. This dual-biomarker strategy enables earlier identification of high-risk patients and supports more precise clinical management.Keywords: NT-proBNP, cTnI, combined testing, children, mycoplasma pneumoniae pneumonia, myocardial injury, diagnostic efficacy, ROChttps://www.dovepress.com/diagnostic-efficacy-of-combined-n-terminal-pro-brain-natriuretic-pepti-peer-reviewed-fulltext-article-JMDHNT-proBNPcTnIcombined testingchildrenMycoplasma pneumoniae pneumoniamyocardial injury |
| spellingShingle | Yang M Xuan A Zhu G Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia Journal of Multidisciplinary Healthcare NT-proBNP cTnI combined testing children Mycoplasma pneumoniae pneumonia myocardial injury |
| title | Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia |
| title_full | Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia |
| title_fullStr | Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia |
| title_full_unstemmed | Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia |
| title_short | Diagnostic Efficacy of Combined N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Cardiac Troponin I (cTnI) Testing in Myocardial Injury of Children with Mycoplasma Pneumoniae Pneumonia |
| title_sort | diagnostic efficacy of combined n terminal pro brain natriuretic peptide nt probnp and cardiac troponin i ctni testing in myocardial injury of children with mycoplasma pneumoniae pneumonia |
| topic | NT-proBNP cTnI combined testing children Mycoplasma pneumoniae pneumonia myocardial injury |
| url | https://www.dovepress.com/diagnostic-efficacy-of-combined-n-terminal-pro-brain-natriuretic-pepti-peer-reviewed-fulltext-article-JMDH |
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