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N-terminal pro-brain natriuretic peptide on admission has prognostic value across the whole spectrum of acute coronary syndromes.
Circulation 2004; 110(2):128-34Circ

Abstract

BACKGROUND

The prognostic value of natriuretic peptide elevations in patients with acute coronary syndromes (ACS) is still incompletely defined. We measured N-terminal pro-brain natriuretic peptide (NT-proBNP) on admission in patients with ACS and ECG evidence of myocardial ischemia.

METHODS AND RESULTS

The NT-proBNP was measured at a median time of 3 hours after symptom onset in 1756 patients. The outcome measure was death at 30 days, which occurred in 113 patients (6.4%). The median NT-proBNP level was 353 ng/L (107 to 1357 ng/L). Compared with the lowest quartile, patients in the second, third, and fourth quartiles had a relative risk of subsequent death of 2.94 (95% CI, 1.15 to 7.52), 5.32 (95% CI, 2.19 to 12.91), and 11.5 (95% CI, 4.90 to 26.87), respectively. The NT-proBNP was independently associated with death in a logistic regression model, which included clinical variables, ECG, and troponin T in patients either with (OR of highest versus lowest quartile, 7.0; 95% CI, 1.9 to 25.6) or without (OR of highest versus lowest quartile, 4.1; 95% CI, 1.1 to 14.6) persistent ST-segment elevation. NT-proBNP was also an independent predictor of severe heart failure.

CONCLUSIONS

The measurement of NT-proBNP on admission improves the early risk stratification of patients with ACS, suggesting the need for the development of targeted therapeutic strategies.

Authors+Show Affiliations

Ospedale G.B. Morgagni and Fondazione Sacco, Forlì, Italy. galvanim@tin.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Studies
Journal Article

Language

eng

PubMed ID

15197143

Citation

Galvani, Marcello, et al. "N-terminal Pro-brain Natriuretic Peptide On Admission Has Prognostic Value Across the Whole Spectrum of Acute Coronary Syndromes." Circulation, vol. 110, no. 2, 2004, pp. 128-34.
Galvani M, Ottani F, Oltrona L, et al. N-terminal pro-brain natriuretic peptide on admission has prognostic value across the whole spectrum of acute coronary syndromes. Circulation. 2004;110(2):128-34.
Galvani, M., Ottani, F., Oltrona, L., Ardissino, D., Gensini, G. F., Maggioni, A. P., ... Vecchio, C. (2004). N-terminal pro-brain natriuretic peptide on admission has prognostic value across the whole spectrum of acute coronary syndromes. Circulation, 110(2), pp. 128-34.
Galvani M, et al. N-terminal Pro-brain Natriuretic Peptide On Admission Has Prognostic Value Across the Whole Spectrum of Acute Coronary Syndromes. Circulation. 2004 Jul 13;110(2):128-34. PubMed PMID: 15197143.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - N-terminal pro-brain natriuretic peptide on admission has prognostic value across the whole spectrum of acute coronary syndromes. AU - Galvani,Marcello, AU - Ottani,Filippo, AU - Oltrona,Luigi, AU - Ardissino,Diego, AU - Gensini,Gian Franco, AU - Maggioni,Aldo P, AU - Mannucci,Pier Mannuccio, AU - Mininni,Nicola, AU - Prando,Maria Domenica, AU - Tubaro,Marco, AU - Vernocchi,Arialdo, AU - Vecchio,Carlo, AU - ,, Y1 - 2004/06/14/ PY - 2004/6/16/pubmed PY - 2005/1/11/medline PY - 2004/6/16/entrez SP - 128 EP - 34 JF - Circulation JO - Circulation VL - 110 IS - 2 N2 - BACKGROUND: The prognostic value of natriuretic peptide elevations in patients with acute coronary syndromes (ACS) is still incompletely defined. We measured N-terminal pro-brain natriuretic peptide (NT-proBNP) on admission in patients with ACS and ECG evidence of myocardial ischemia. METHODS AND RESULTS: The NT-proBNP was measured at a median time of 3 hours after symptom onset in 1756 patients. The outcome measure was death at 30 days, which occurred in 113 patients (6.4%). The median NT-proBNP level was 353 ng/L (107 to 1357 ng/L). Compared with the lowest quartile, patients in the second, third, and fourth quartiles had a relative risk of subsequent death of 2.94 (95% CI, 1.15 to 7.52), 5.32 (95% CI, 2.19 to 12.91), and 11.5 (95% CI, 4.90 to 26.87), respectively. The NT-proBNP was independently associated with death in a logistic regression model, which included clinical variables, ECG, and troponin T in patients either with (OR of highest versus lowest quartile, 7.0; 95% CI, 1.9 to 25.6) or without (OR of highest versus lowest quartile, 4.1; 95% CI, 1.1 to 14.6) persistent ST-segment elevation. NT-proBNP was also an independent predictor of severe heart failure. CONCLUSIONS: The measurement of NT-proBNP on admission improves the early risk stratification of patients with ACS, suggesting the need for the development of targeted therapeutic strategies. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/15197143/N_terminal_pro_brain_natriuretic_peptide_on_admission_has_prognostic_value_across_the_whole_spectrum_of_acute_coronary_syndromes_ L2 - http://www.ahajournals.org/doi/full/10.1161/01.CIR.0000134480.06723.D8?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -