Analysis of N-terminal pro-B-type natriuretic peptide in patients with acute coronary syndromes

Giuseppe Coppola, Egle Corrado, Maria Cristina Mulè, Stefano Augugliaro, Angela Cucchiara, Giuseppina Novo, Gisella Amoroso, Pasquale Assennato, Enrico Hoffmann, Francesco Vitale, Salvatore Novo
Coronary Artery Disease 2009, 20 (3): 225-9

BACKGROUND: The N-terminal portion of brain natriuretic peptide (NT-proBNP) has been identified as an indicator of prognosis in different cardiovascular diseases. The objective of this study was to determine the utility of measuring plasma NT-proBNP levels in patients with acute coronary syndromes.

METHODS AND RESULTS: We studied 66 patients admitted in our division for acute coronary syndromes. Patients underwent a venous blood sample within 24 h from the admission to determine NT-proBNP levels. Increasing plasma levels of NT-proBNP (in tertiles) was associated with a greater history of hypertension and current smoking, whereas biochemical parameters were associated with higher level of creatine kinase-MB mass, cardiac troponin I, and renal insufficiency. We detected correlations between the values of NT-proBNP and several variables; positive correlations were found between the values of NT-proBNP and creatinine (r=+0354; P=0.0024), cardiac troponin I levels (r=0320; P=0.0111), and creatine kinase-MB mass values (r=0261; P=0.035). An interesting result of our study was a significantly longer hospitalization in those patients belonging to the third tertile compared with those belonging to the first one (P=0.02). Finally, we showed a higher N-terminal brain natriuretic peptide level in patients with poor outcome during the hospitalization (left-ventricular systolic dysfunction, recurrent ischemic events, or death) compared with those who did not (3204+/-1841 vs. 836+/-1136, P=0.003).

CONCLUSION: Measurement of B-type natriuretic peptide provides predictive information during the hospitalization in patients with acute coronary syndromes.

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