A prospective cohort study of prognostic power of N-terminal probrain natriuretic peptide in patients with non-ST segment elevation acute coronary syndromes

Gjin Ndrepepa, Siegmund Braun, Julinda Mehilli, Kathrin Niemöller, Albert Schömig, Adnan Kastrati
Clinical Research in Cardiology: Official Journal of the German Cardiac Society 2007, 96 (1): 30-7

BACKGROUND: Braintype natriuretic peptide (BNP) or N-terminal segment of the prohormone (NT-proBNP) measured within the first few days after symptom onset offer prognostic information in patients with non- ST elevation acute coronary syndromes (ACS).

METHODS AND RESULTS: This prospective cohort study included 493 patients with non-ST segment elevation ACS who underwent percutaneous coronary intervention in the Deutsches Herzzentrum and Klinikum rechts der Isar in Munich, Germany. NT-proBNP was measured on admission. Patients were divided into four groups according to quartiles of NT-proBNP. The primary end point of the study was mortality. Patients were followed for a median of 4.0 years [interquartile range 3.6 to 4.9 years]. During this time period, there were 65 deaths: 4 deaths in the 1st quartile, 9 deaths in the 2nd quartile, 16 deaths in the 3rd quartile and 36 deaths in the 4th quartile (Kaplan-Meier estimates of mortality: 3.4, 7.8, 16.0 and 33.9%; odds ratio [OR] 10.2, 95% confidence interval [CI] 4.5 to 23.5; P< 0.001 for 4th vs 1st quartile). Patients in the upper quartile of NT-proBNP had a more adverse cardiovascular risk profile than patients in lower quartiles of NT-proBNP. After adjustment in the Cox proportional hazards model, the NT-proBNP remained an independent correlate of mortality (adjusted hazard ratio [HR] 1.23, 95% confidence interval [CI] 1.04 to 1.45, P = 0.014 for 4th vs 1st quartiles) but weaker than age (adjusted HR 2.11, 95% CI 1.53 to 2.90; P < 0.001 for a 10-year increase in age) or left ventricular ejection fraction (adjusted HR 1.35, 95% CI 1.09 to 1.68; P = 0.007 for a 10% decrease).

CONCLUSION: N-terminal probrain natriuretic peptide is a marker of weak-to-moderate strength in predicting the long-term prognosis in patients with non-ST segment elevation acute coronary syndromes after percutaneous coronary intervention.

Full Text Links

Find Full Text Links for this Article


You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read

Save your favorite articles in one place with a free QxMD account.


Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"