The value of NT-PROBNP in early risk stratification of acute coronary syndromes

• Type: Article in International Scientific Journal
• Date: 2006

Authors

Rui Coelho (Author) FMUP; Mariano, L (Author) Other; Gavina C (Author) FMUP; Pinho, T (Author) Other; Vasconcelos, M (Author) Other; Ferreira A (Author) FMUP; Maciel MJ (Author) FMUP; Goncalves, FR (Author) Other

Journal

Title: Revista Portuguesa de Cardiologia

Vol. 25

Pages: 71-75

ISSN: 0870-2551

Publisher: Sociedade Portuguesa De Cardiologia

Indexing

Scopus - 2 Citations

Other information

Authenticus ID: P-007-FB6

Abstract (EN): Introduction: The N-terminal portion of brain natriuretic peptide (NT-proBNP) has been identified as an indicator of prognosis in different, cardiovascular diseases. Its role in risk stratification in patients with acute coronary syndromes (ACS) is still under evaluation. Objective: We aimed to evaluate the prognostic value of NT-proBNP measured in the first 48 hours after admission due to an acute coronary syndrome. Methods: Our study included 142 patients (aged 62.7±12.0 years, 70.4% males) admitted to a cardiology unit with an ACS. All laboratory evaluations were performed in the first 48 hours alter admission. The mean follow-up was 200 days. Death from any cause or hospitalization because of a major acute cardiovascular event (whichever occurred first) was defined as the end-point. Results: Cardiovascular risk factors were found in a significant proportion of our sample (hypertension in 56.3%, diabetes mellitus in 38.0%, current or previous smoking in 51.4%, dyslipidemia in 67.6%). Fifty-eight patients had left ventricular systolic dysfunction (LVSD). Serum levels of NT-proBNP were 217±4801 pg/ml. Variables associated with event-free survival in univariate analysis were: NT-proBNP (HR 1.007. 95% CI 1.003-1.011, for each 100 pg/ml increment), serum glucose (hazard ratio [HR] 1.007, 95% CI 1.001-1.012, for each 1 mg/dl increment) and maximum cardiac troponin I (cTnI) level (HR 1.005. 95% CI 1.001-1.009, for each 1 ng/ml increment). The white blood count (WBG) was marginally associated with a poor prognosis (HR 1.152, 95% CI 0.994-1.335, for each 1000/mm3 increment). After adjustment for the above variables, age, sex, left ventricular systolic dysfunction, diabetes, coronary anatomy and coronary revascularization using a forward likelihood ratio Cox regression model, NT-proBNP remained the only variable with significant prognostic value (HR 1,007, 95% CI 1.003-1.011, for each 100 pg/ml increment). Conclusions: These data suggest that NT-proBNP is a strong clinical predictor of prognosis in acute coronary syndromes. Its early measurement should be included in the risk stratification strategy in this setting.

Language: English

Type (Professor's evaluation): Scientific