NT-proBNP for prognostic and diagnostic evaluation in patients with acute coronary syndromes
Abstract
Background and aim: N terminal-proB-type natriuretic peptide (NT-proBNP) is synthesised and secreted from the ventricularmyocardium. This marker is known to be elevated in patients with acute coronary syndromes (ACS). We evaluated NT-proBNP asa significant diagnostic marker and an important independent predictor of short-term mortality (one month) in patients with ACS.
Methods: NT-proBNP and cardiac troponin I (cTI) were assessed in 134 consecutive patients (median age 66 years, 73% male)hospitalised for ACS in a cardiological university department. The patients were classified into ST-elevation ACS (STE-ACS, n = 74) and non-ST-elevation ACS (NSTE-ACS, n = 60) groups based on the ECG findings on admission. Patients with Killipclass ≥ II were excluded.
Results: The serum level of NT-proBNP on admission was significantly higher (p < 0.0005), while there was no differencein cTI serum level in the NSTE-ACS patients compared to STE-ACS patients. There was a significant positive correlation betweenNT-proBNP and cTI in the NSTE-ACS (r = 0.338, p = 0.008) and STE-ACS (r = 0.441, p < 0.0005) patients. Therewas a significant difference in NT-proBNP (p < 0.0005) and cTI (p < 0.0005) serum level between ACS patients who diedwithin 30 days or who survived after one month. The increased NT-proBNP level is the strongest predictor of mortality in ACSpatients, also NT-proBNP cut-point level of 1,490 pg/mL is a significant independent predictor of mortality.
Conclusions: We demonstrated the differences and the correlation in the secretion of NT-proBNP and cTI in patients withSTE-ACS vs. NSTE-ACS. Our results provide evidence that NT-proBNP is a significant diagnostic marker and an importantindependent predictor of short-term mortality in patients with ACS.
Keywords: acute coronary syndromesNT-proBNPtroponin Iprognosis