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Serial analyses of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes: a Fragmin and fast Revascularisation during In Stability in Coronary artery disease (FRISC)-II substudy.
J Am Coll Cardiol 2005; 45(4):533-41JACC

Abstract

OBJECTIVES

The aim of this research was to describe N-terminal part of the pro-B-type natriuretic peptide (NT-proBNP) levels over time in non-ST-segment elevation acute coronary syndromes (NSTEACS), to elucidate factors associated with changes of NT-proBNP levels, and to examine association with long-term mortality.

BACKGROUND

The NT-proBNP levels are associated with mortality. Long-term temporal changes of NT-proBNP levels and their relation to other factors have not been examined.

METHODS

The NT-proBNP was analyzed at randomization and at 48 h, after 6 weeks, 3 and 6 months in NSTEACS patients enrolled in the Fragmin and fast Revascularisation during InStability in Coronary artery disease (FRISC)-II trial. The NT-proB-type natriuretic peptide was analyzed at least three time points in 1,216 patients.

RESULTS

The median NT-proBNP level, which at randomization was 529 ng/l, decreased throughout the whole sampling period to 238 ng/l at six months. Elevated troponin T, C-reactive protein, and female gender were associated with higher reduction rates, and high age, diabetes, previous myocardial infarction, treatment with diuretics, and nitrates on admission with lower reduction rates. At each time point, the NT-proBNP level was predictive of the two-year mortality. However, the adjusted odds ratio increased for each time point.

CONCLUSIONS

The initial rise of NT-proBNP in NSTEACS is mainly reversible. Factors associated with less reversibility are related to chronically impaired left ventricular function, and factors associated with greater reversibility are related to the acute myocardial damage. The NT-proBNP level measured during a chronic, relatively stable phase is a better predictor of mortality than during an acute unstable phase. The clinical setting and timing of measurement will be important to consider when using NT-proBNP for risk assessment.

Authors+Show Affiliations

Department of Medical Sciences and Cardiology, Uppsala Clinical Research Center, University Hospital, Uppsala, Sweden. bertil.lindahl@akademiska.se <bertil.lindahl@akademiska.se>No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15708700

Citation

Lindahl, Bertil, et al. "Serial Analyses of N-terminal pro-B-type Natriuretic Peptide in Patients With non-ST-segment Elevation Acute Coronary Syndromes: a Fragmin and Fast Revascularisation During in Stability in Coronary Artery Disease (FRISC)-II Substudy." Journal of the American College of Cardiology, vol. 45, no. 4, 2005, pp. 533-41.
Lindahl B, Lindbäck J, Jernberg T, et al. Serial analyses of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes: a Fragmin and fast Revascularisation during In Stability in Coronary artery disease (FRISC)-II substudy. J Am Coll Cardiol. 2005;45(4):533-41.
Lindahl, B., Lindbäck, J., Jernberg, T., Johnston, N., Stridsberg, M., Venge, P., & Wallentin, L. (2005). Serial analyses of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes: a Fragmin and fast Revascularisation during In Stability in Coronary artery disease (FRISC)-II substudy. Journal of the American College of Cardiology, 45(4), pp. 533-41.
Lindahl B, et al. Serial Analyses of N-terminal pro-B-type Natriuretic Peptide in Patients With non-ST-segment Elevation Acute Coronary Syndromes: a Fragmin and Fast Revascularisation During in Stability in Coronary Artery Disease (FRISC)-II Substudy. J Am Coll Cardiol. 2005 Feb 15;45(4):533-41. PubMed PMID: 15708700.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Serial analyses of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes: a Fragmin and fast Revascularisation during In Stability in Coronary artery disease (FRISC)-II substudy. AU - Lindahl,Bertil, AU - Lindbäck,Johan, AU - Jernberg,Tomas, AU - Johnston,Nina, AU - Stridsberg,Mats, AU - Venge,Per, AU - Wallentin,Lars, PY - 2004/05/04/received PY - 2004/10/21/revised PY - 2004/10/25/accepted PY - 2005/2/15/pubmed PY - 2005/3/18/medline PY - 2005/2/15/entrez SP - 533 EP - 41 JF - Journal of the American College of Cardiology JO - J. Am. Coll. Cardiol. VL - 45 IS - 4 N2 - OBJECTIVES: The aim of this research was to describe N-terminal part of the pro-B-type natriuretic peptide (NT-proBNP) levels over time in non-ST-segment elevation acute coronary syndromes (NSTEACS), to elucidate factors associated with changes of NT-proBNP levels, and to examine association with long-term mortality. BACKGROUND: The NT-proBNP levels are associated with mortality. Long-term temporal changes of NT-proBNP levels and their relation to other factors have not been examined. METHODS: The NT-proBNP was analyzed at randomization and at 48 h, after 6 weeks, 3 and 6 months in NSTEACS patients enrolled in the Fragmin and fast Revascularisation during InStability in Coronary artery disease (FRISC)-II trial. The NT-proB-type natriuretic peptide was analyzed at least three time points in 1,216 patients. RESULTS: The median NT-proBNP level, which at randomization was 529 ng/l, decreased throughout the whole sampling period to 238 ng/l at six months. Elevated troponin T, C-reactive protein, and female gender were associated with higher reduction rates, and high age, diabetes, previous myocardial infarction, treatment with diuretics, and nitrates on admission with lower reduction rates. At each time point, the NT-proBNP level was predictive of the two-year mortality. However, the adjusted odds ratio increased for each time point. CONCLUSIONS: The initial rise of NT-proBNP in NSTEACS is mainly reversible. Factors associated with less reversibility are related to chronically impaired left ventricular function, and factors associated with greater reversibility are related to the acute myocardial damage. The NT-proBNP level measured during a chronic, relatively stable phase is a better predictor of mortality than during an acute unstable phase. The clinical setting and timing of measurement will be important to consider when using NT-proBNP for risk assessment. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/15708700/Serial_analyses_of_N_terminal_pro_B_type_natriuretic_peptide_in_patients_with_non_ST_segment_elevation_acute_coronary_syndromes:_a_Fragmin_and_fast_Revascularisation_during_In_Stability_in_Coronary_artery_disease__FRISC__II_substudy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(04)02251-X DB - PRIME DP - Unbound Medicine ER -