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Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes?
Acute Card Care 2009; 11(4):236-42AC

Abstract

BACKGROUND

NT-proBNP has prognostic implications in heart failure. In acute coronary syndromes (ACS) setting, the prognostic significance of NT-proBNP is being sought. We studied short-term prognostic impact of admission NT-proBNP in patients admitted for ACS and in association with GRACE risk score (GRS).

METHODS AND RESULTS

We studied 1035 patients admitted with ACS. Patients were divided in quartiles according to NT-proBNP levels on admission: Q1 <180 pg/ml; Q2 180-691 pg/ml; Q3 696-2664 pg/ml; Q4 2698-35 000 pg/ml. Groups were compared in terms of short-term all-cause mortality. Patients with higher NT-proBNP had worst GRS on admission. They also received less aggressive treatment. In-hospital mortality was 0.8%, 3.0%, 5.8% and 12.8% (P<0.001) and 30-day mortality 1.6%, 4.6%, 6.5% and 16.7% (P<0.001) respectively. In multivariate logistic regression analysis, NT-proBNP is an independent predictor of in-hospital (OR 2.35; 95% CI: 1.12-4.93, P=0.022) and 30-day mortality (OR 2.20; 95% CI: 1.17-4.12, P=0.014). However, NT-proBNP does not add any incremental benefit to GRS for prediction of outcome by ROC curve analysis.

CONCLUSIONS

NT-proBNP is an independent predictor of in-hospital and 30-day mortality after ACS, independently of left ventricular function, but does not increase the prognostic accuracy of GRS.

Authors+Show Affiliations

Cardiology Department, Santa Marta Hospital, Lisbon, Portugal. ana_timoteo@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
Validation Studies

Language

eng

PubMed ID

19742352

Citation

Timóteo, Ana Teresa, et al. "Does Admission NT-proBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-term Mortality After Acute Coronary Syndromes?" Acute Cardiac Care, vol. 11, no. 4, 2009, pp. 236-42.
Timóteo AT, Toste A, Ramos R, et al. Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes? Acute Card Care. 2009;11(4):236-42.
Timóteo, A. T., Toste, A., Ramos, R., Miranda, F., Ferreira, M. L., Oliveira, J. A., & Ferreira, R. C. (2009). Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes? Acute Cardiac Care, 11(4), pp. 236-42. doi:10.1080/17482940903177036.
Timóteo AT, et al. Does Admission NT-proBNP Increase the Prognostic Accuracy of GRACE Risk Score in the Prediction of Short-term Mortality After Acute Coronary Syndromes. Acute Card Care. 2009;11(4):236-42. PubMed PMID: 19742352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes? AU - Timóteo,Ana Teresa, AU - Toste,Alexandra, AU - Ramos,Ruben, AU - Miranda,Fernando, AU - Ferreira,Maria Lurdes, AU - Oliveira,José Alberto, AU - Ferreira,Rui Cruz, PY - 2009/9/11/entrez PY - 2009/9/11/pubmed PY - 2010/3/2/medline SP - 236 EP - 42 JF - Acute cardiac care JO - Acute Card Care VL - 11 IS - 4 N2 - BACKGROUND: NT-proBNP has prognostic implications in heart failure. In acute coronary syndromes (ACS) setting, the prognostic significance of NT-proBNP is being sought. We studied short-term prognostic impact of admission NT-proBNP in patients admitted for ACS and in association with GRACE risk score (GRS). METHODS AND RESULTS: We studied 1035 patients admitted with ACS. Patients were divided in quartiles according to NT-proBNP levels on admission: Q1 <180 pg/ml; Q2 180-691 pg/ml; Q3 696-2664 pg/ml; Q4 2698-35 000 pg/ml. Groups were compared in terms of short-term all-cause mortality. Patients with higher NT-proBNP had worst GRS on admission. They also received less aggressive treatment. In-hospital mortality was 0.8%, 3.0%, 5.8% and 12.8% (P<0.001) and 30-day mortality 1.6%, 4.6%, 6.5% and 16.7% (P<0.001) respectively. In multivariate logistic regression analysis, NT-proBNP is an independent predictor of in-hospital (OR 2.35; 95% CI: 1.12-4.93, P=0.022) and 30-day mortality (OR 2.20; 95% CI: 1.17-4.12, P=0.014). However, NT-proBNP does not add any incremental benefit to GRS for prediction of outcome by ROC curve analysis. CONCLUSIONS: NT-proBNP is an independent predictor of in-hospital and 30-day mortality after ACS, independently of left ventricular function, but does not increase the prognostic accuracy of GRS. SN - 1748-295X UR - https://www.unboundmedicine.com/medline/citation/19742352/Does_admission_NT_proBNP_increase_the_prognostic_accuracy_of_GRACE_risk_score_in_the_prediction_of_short_term_mortality_after_acute_coronary_syndromes L2 - http://www.tandfonline.com/doi/full/10.1080/17482940903177036 DB - PRIME DP - Unbound Medicine ER -