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Additive prognostic value of NT-proBNP over TIMI risk score in intermediate-risk patients with acute coronary syndrome.
Turk Kardiyol Dern Ars 2009; 37(1):1-8TK

Abstract

OBJECTIVES

We evaluated the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) for further risk stratification of intermediate-risk patients with non-ST elevation acute coronary syndromes (NSTE-ACS).

STUDY DESIGN

The study included 137 intermediate-risk patients (85 men, 52 women; mean age 62+/-11 years) with ACS, based on the TIMI risk score (scores 3 to 5). Serum NT-proBNP levels were measured 12 hours after the last anginal episode. The patients were divided into four groups according to the following NT-proBNP quartiles: 17-310 pg/ml (n=34), 313-688 pg/ml (n=35), 724-2,407 pg/ml (n=34), and 2,575-24,737 pg/ml (n=34). Primary endpoint of the study was mortality. The mean follow-up was 21.8+/-7.1 months.

RESULTS

There were 27 deaths (19.7%), 14 of which were in the 4th quartile (4th vs 1st, 2nd, and 3rd quartiles: p=0.02, p=0.01, and p<0.01, respectively). The first three quartiles did not differ significantly in this respect. In Kaplan-Meier analysis, patients in the 4th quartile had the lowest cumulative survival (log rank test, 4th vs 1st, 2nd, and 3rd quartiles: p=0.041, p=0.026, and p=0.009, respectively). NT-proBNP level was significantly higher in nonsurvivors than in survivors (p=0.01). In univariate analysis, mortality was also associated with the TIMI risk score, ejection fraction, and age. Patients who died were older (65.6+/-11.9 years vs 60.7+/-11.0 years; p=0.048) and had a lower ejection fraction (46.3+/-11% vs 54.1+/-9.8%; p<0.001) than patients who survived. Mortality rates corresponding to TIMI risk scores of 3, 4, and 5 were 25.9%, 29.6%, and 44.4%, respectively (p=0.58 for TIMI 3 vs 4; p=0.001 for TIMI 3 vs 5; p=0.013 for TIMI 4 vs 5). Cox proportional hazards regression analysis showed that only TIMI risk score was an independent predictor of mortality (hazard ratio 2.3, 95% confidence interval 1.4-3.8, p=0.001).

CONCLUSION

NT-proBNP has an additive predictive value over TIMI risk score in predicting long-term mortality in intermediate-risk patients with ACS.

Authors+Show Affiliations

Department of Cardiology, Izmir Atatürk Training and Research Hospital, Izmir, Turkey. nkahya77@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19225247

Citation

Eren, Nihan Kahya, et al. "Additive Prognostic Value of NT-proBNP Over TIMI Risk Score in Intermediate-risk Patients With Acute Coronary Syndrome." Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir, vol. 37, no. 1, 2009, pp. 1-8.
Eren NK, Ertaş F, Yüksek U, et al. Additive prognostic value of NT-proBNP over TIMI risk score in intermediate-risk patients with acute coronary syndrome. Turk Kardiyol Dern Ars. 2009;37(1):1-8.
Eren, N. K., Ertaş, F., Yüksek, U., Cakir, C., Nazli, C., Köseoğlu, M., & Ergene, O. (2009). Additive prognostic value of NT-proBNP over TIMI risk score in intermediate-risk patients with acute coronary syndrome. Turk Kardiyoloji Dernegi Arsivi : Turk Kardiyoloji Derneginin Yayin Organidir, 37(1), pp. 1-8.
Eren NK, et al. Additive Prognostic Value of NT-proBNP Over TIMI Risk Score in Intermediate-risk Patients With Acute Coronary Syndrome. Turk Kardiyol Dern Ars. 2009;37(1):1-8. PubMed PMID: 19225247.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Additive prognostic value of NT-proBNP over TIMI risk score in intermediate-risk patients with acute coronary syndrome. AU - Eren,Nihan Kahya, AU - Ertaş,Faruk, AU - Yüksek,Umit, AU - Cakir,Cayan, AU - Nazli,Cem, AU - Köseoğlu,Mehmet, AU - Ergene,Oktay, PY - 2009/2/20/entrez PY - 2009/2/20/pubmed PY - 2009/12/16/medline SP - 1 EP - 8 JF - Turk Kardiyoloji Dernegi arsivi : Turk Kardiyoloji Derneginin yayin organidir JO - Turk Kardiyol Dern Ars VL - 37 IS - 1 N2 - OBJECTIVES: We evaluated the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) for further risk stratification of intermediate-risk patients with non-ST elevation acute coronary syndromes (NSTE-ACS). STUDY DESIGN: The study included 137 intermediate-risk patients (85 men, 52 women; mean age 62+/-11 years) with ACS, based on the TIMI risk score (scores 3 to 5). Serum NT-proBNP levels were measured 12 hours after the last anginal episode. The patients were divided into four groups according to the following NT-proBNP quartiles: 17-310 pg/ml (n=34), 313-688 pg/ml (n=35), 724-2,407 pg/ml (n=34), and 2,575-24,737 pg/ml (n=34). Primary endpoint of the study was mortality. The mean follow-up was 21.8+/-7.1 months. RESULTS: There were 27 deaths (19.7%), 14 of which were in the 4th quartile (4th vs 1st, 2nd, and 3rd quartiles: p=0.02, p=0.01, and p<0.01, respectively). The first three quartiles did not differ significantly in this respect. In Kaplan-Meier analysis, patients in the 4th quartile had the lowest cumulative survival (log rank test, 4th vs 1st, 2nd, and 3rd quartiles: p=0.041, p=0.026, and p=0.009, respectively). NT-proBNP level was significantly higher in nonsurvivors than in survivors (p=0.01). In univariate analysis, mortality was also associated with the TIMI risk score, ejection fraction, and age. Patients who died were older (65.6+/-11.9 years vs 60.7+/-11.0 years; p=0.048) and had a lower ejection fraction (46.3+/-11% vs 54.1+/-9.8%; p<0.001) than patients who survived. Mortality rates corresponding to TIMI risk scores of 3, 4, and 5 were 25.9%, 29.6%, and 44.4%, respectively (p=0.58 for TIMI 3 vs 4; p=0.001 for TIMI 3 vs 5; p=0.013 for TIMI 4 vs 5). Cox proportional hazards regression analysis showed that only TIMI risk score was an independent predictor of mortality (hazard ratio 2.3, 95% confidence interval 1.4-3.8, p=0.001). CONCLUSION: NT-proBNP has an additive predictive value over TIMI risk score in predicting long-term mortality in intermediate-risk patients with ACS. SN - 1016-5169 UR - https://www.unboundmedicine.com/medline/citation/19225247/Additive_prognostic_value_of_NT_proBNP_over_TIMI_risk_score_in_intermediate_risk_patients_with_acute_coronary_syndrome_ L2 - https://www.journalagent.com/pubmed/linkout.asp?ISSN=1016-5169&amp;PMID=19225247 DB - PRIME DP - Unbound Medicine ER -