Revista argentina de cardiología
versión On-line ISSN 1850-3748
HIGA, Claudio C. et al. N-Terminal Pro B Type Natriuretic Peptide: A Predictor of Adverse Outcome in Coronary Syndrome Patients without ST-Segment Elevation. Rev. argent. cardiol. [online]. 2005, vol.73, n.4, pp. 257-263. ISSN 1850-3748.
Background Brain natriuretic peptide (BNP) is a strong predictor of adverse outcomes in patients with acute coronary syndromes. Therefore, it is expected that N terminal pro B type natriuretic peptide (NT Pro-BNP) should be a useful early risk stratification marker in this setting. Research Design and Methods We measured NT Pro-BNP, troponin T, CK-MB mass, C reactive protein and myoglobin in serum samples obtained from 254 patients enrolled in a prospective multicentric cohort of non ST-segment elevation coronary syndrome patients. Primary end point was 30-day mortality. Results The overall 30-day mortality rate was 3.8%. NT Pro-BNP levels were measured in samples obtained at a median time of 4.9 hours (from admission) and at a median time of 12 hours. NT Pro-BNP concentration was significantly lower in patients who survived (392.5 pg/ml) than in those who died (2706 pg/ml), p = 0.003. Stepwise logistic regression analysis including significant predictors (ST deviation and elevated markers) showed that both admission NT Pro-BNP levels (OR 5 [95% CI: 1-24.9] p = 0.04) and 12 hs NT Pro-BNP levels (OR 3.4 [95% CI: 1.1-9.7] p = 0.02) were independent predictors of 30- day mortality. Conclusion NT Pro-BNP is an early and independent predictor of adverse short-term outcome in patients with non ST-segment elevation coronary syndromes.
Palabras clave : Natriuretic peptides; Myocardial ischemia; Prognosis.