Journal List > Korean Circ J > v.34(11) > 1074580

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Baek, Jeon, Rhee, Kim, Kim, Song, Ryu, Choi, Sung, Lee, Park, Gwon, Kim, Kim, Lee, Hong, and Park: N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Marker in Acute Coronary Syndrome
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Korean Circulation Journal

Korean Circulation Journal 2004; 34(11): 1070-1081.

Published online: 30 November 2004

DOI: https://doi.org/10.4070/kcj.2004.34.11.1070

N-Terminal Pro-B-Type Natriuretic Peptide as a Prognostic Marker in Acute Coronary Syndrome

Kyung Kee Baek, Eun Seok Jeon, IL Rhee, Sung Hea Kim, Je Sang Kim, Pil Sang Song, Dong Ryeol Ryu, Jin Ho Choi, Ji Dong Sung, Sang Chol Lee, Seung Woo Park, Hyun Cheol Gwon, June Soo Kim, Duk Kyung Kim, Sang Hoon Lee, Kyung Pyo Hong, Jeong Euy Park

Division of Cardiology, Cardiovascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

esjeon@smc.samsung.co.kr

Copyright © 2004 The Korean Society of Circulation

Abstract

BACKGROUND AND OBJECTIVES: Biochemical markers are useful for the prediction of cardiac events in patients with acute coronary syndrome (ACS). The N-terminal fragment of the BNP prohormone (NT-proBNP), which is synthesized by cardiac ventricles in response to increased wall stress, may be a prognostic marker in ACS. The relation between the NT-pro BNP levels on admission and major adverse cardiovascular events (MACEs) were assessed in a cohort of patients with ACS.
SUBJECTS AND METHODS: Between October 2002 and April 2004, blood samples for the determination of NT-proBNP level were obtained on admission from 78 patients with ST-elevation myocardial infarction (STEMI), 32 with non-ST elevation MI(NSTEMI) and 66 with unstable angina (UA). Patients were followed concerning MACEs (death, MI, heart failure, stroke and revascularization) for a median of 7 months in median.
RESULTS: 22 patients (13%) had events. The mean NT-proBNP level was significantly lower in the event-free survivors than in those with events (1342±1598 versus 6129±6522 pg/mL, p<0.0001). The optimal cut-off value of the NT-proBNP level using a receiver-operating-characteristic curve was 1445 pg/mL. The unadjusted risk ratio of patients with an NT-proBNP level greater than the threshold was 7.0 (95% confidence interval, 2.6 to 19.0). In a multivariate Cox regression model, including clinical background factors and other biochemical markers, the NT-proBNP level was the most powerful indicator of MACEs (risk ratio, 8.0 [95% confidence interval, 1.7 to 37.1]). The coronary angiographic Gensini score was also a predictor of prognosis in ACS (risk ratio, 3.8 [95% confidence interval, 1.0 to 14.0]).
CONCLUSION: A single measurement of the NT-proBNP level on admission appears to be useful as a prognostic factor in the prediction of MACEs in patients after ACS.

Keywords: B-type natriuretic peptides, Prognosis

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