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[Relationship between plasma N-terminal pro-brain natriuretic peptide and GRACE risk stratification in non-ST-segment elevation acute coronary syndrome].
Zhonghua Xin Xue Guan Bing Za Zhi. 2012 May; 40(5):373-7.ZX

Abstract

OBJECTIVE

To explore the relationship between plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level obtained on admission and global registry of acute coronary events (GRACE) scores and the value for risk stratification in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS).

METHODS

A total of 231 NSTE-ACS patients admitted in our hospital between June 2009 and September 2010 were included [161 patients with unstable angina (UA) and 70 patients with non-ST-segment elevation myocardial infarction (NSTEMI)]. On admission plasma NT-proBNP was measured in all patients. The GRACE risk score were used for risk assessment. Patients were followed up for 6 months and incidence of new or recurrent myocardial infarction, target vessel revascularization, cardiac death, heart failure (MACE) was recorded.

RESULTS

According to GRACE risk stratification, there were 62 low-risk patients, 78 middle-risk patients and 91 high-risk patients. lgNT-proBNP level on admission increased in proportion to increasing risk defined by GRACE risk stratification and lgNT-proBNP positively correlated with GRACE risk score (r = 0.59, P < 0.001). The GRACE risk score was the highest in the fourth NT-proBNP quartile (P < 0.001 vs. lowest, second and third quartiles). GRACE score was significantly higher in patients with NT-proBNP level above the 75 percentile compared patients with NT-proBNP under the 75 percentile (P < 0.001). MACE occurred in 9 [3.9% (9/231)] patients during follow up. ROC analysis showed AUC of on admission NT-proBNP was 0.831 (SE = 0.062, P = 0.001, 95%CI 0.711 - 0.952) and AUC of GRACE risk score was 0.799 (SE = 0.079, P = 0.002, 95%CI 0.644 - 0.954) for predicting the short-term risk of MACE (P = 0.75).

CONCLUSION

On admission plasma NT-proBNP level parallels GRACE risk score in NSTE-ACS patients, both on admission plasma NT-proBNP level and GRACE risk score are valuable parameters for risk stratification in patients with NSTE-ACS and increased NT-proBNP level and GRACE values are predictors for increased short-term risk of MACE.

Authors+Show Affiliations

Department of Cardiology, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China.No affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

chi

PubMed ID

22883085

Citation

Liu, Wen-xian, and Han Zhao. "[Relationship Between Plasma N-terminal Pro-brain Natriuretic Peptide and GRACE Risk Stratification in non-ST-segment Elevation Acute Coronary Syndrome]." Zhonghua Xin Xue Guan Bing Za Zhi, vol. 40, no. 5, 2012, pp. 373-7.
Liu WX, Zhao H. [Relationship between plasma N-terminal pro-brain natriuretic peptide and GRACE risk stratification in non-ST-segment elevation acute coronary syndrome]. Zhonghua Xin Xue Guan Bing Za Zhi. 2012;40(5):373-7.
Liu, W. X., & Zhao, H. (2012). [Relationship between plasma N-terminal pro-brain natriuretic peptide and GRACE risk stratification in non-ST-segment elevation acute coronary syndrome]. Zhonghua Xin Xue Guan Bing Za Zhi, 40(5), 373-7.
Liu WX, Zhao H. [Relationship Between Plasma N-terminal Pro-brain Natriuretic Peptide and GRACE Risk Stratification in non-ST-segment Elevation Acute Coronary Syndrome]. Zhonghua Xin Xue Guan Bing Za Zhi. 2012;40(5):373-7. PubMed PMID: 22883085.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Relationship between plasma N-terminal pro-brain natriuretic peptide and GRACE risk stratification in non-ST-segment elevation acute coronary syndrome]. AU - Liu,Wen-xian, AU - Zhao,Han, PY - 2012/8/14/entrez PY - 2012/8/14/pubmed PY - 2013/6/12/medline SP - 373 EP - 7 JF - Zhonghua xin xue guan bing za zhi JO - Zhonghua Xin Xue Guan Bing Za Zhi VL - 40 IS - 5 N2 - OBJECTIVE: To explore the relationship between plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) level obtained on admission and global registry of acute coronary events (GRACE) scores and the value for risk stratification in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: A total of 231 NSTE-ACS patients admitted in our hospital between June 2009 and September 2010 were included [161 patients with unstable angina (UA) and 70 patients with non-ST-segment elevation myocardial infarction (NSTEMI)]. On admission plasma NT-proBNP was measured in all patients. The GRACE risk score were used for risk assessment. Patients were followed up for 6 months and incidence of new or recurrent myocardial infarction, target vessel revascularization, cardiac death, heart failure (MACE) was recorded. RESULTS: According to GRACE risk stratification, there were 62 low-risk patients, 78 middle-risk patients and 91 high-risk patients. lgNT-proBNP level on admission increased in proportion to increasing risk defined by GRACE risk stratification and lgNT-proBNP positively correlated with GRACE risk score (r = 0.59, P < 0.001). The GRACE risk score was the highest in the fourth NT-proBNP quartile (P < 0.001 vs. lowest, second and third quartiles). GRACE score was significantly higher in patients with NT-proBNP level above the 75 percentile compared patients with NT-proBNP under the 75 percentile (P < 0.001). MACE occurred in 9 [3.9% (9/231)] patients during follow up. ROC analysis showed AUC of on admission NT-proBNP was 0.831 (SE = 0.062, P = 0.001, 95%CI 0.711 - 0.952) and AUC of GRACE risk score was 0.799 (SE = 0.079, P = 0.002, 95%CI 0.644 - 0.954) for predicting the short-term risk of MACE (P = 0.75). CONCLUSION: On admission plasma NT-proBNP level parallels GRACE risk score in NSTE-ACS patients, both on admission plasma NT-proBNP level and GRACE risk score are valuable parameters for risk stratification in patients with NSTE-ACS and increased NT-proBNP level and GRACE values are predictors for increased short-term risk of MACE. SN - 0253-3758 UR - https://www.unboundmedicine.com/medline/citation/22883085/[Relationship_between_plasma_N_terminal_pro_brain_natriuretic_peptide_and_GRACE_risk_stratification_in_non_ST_segment_elevation_acute_coronary_syndrome]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0253-3758&amp;year=2012&amp;vol=40&amp;issue=5&amp;fpage=373 DB - PRIME DP - Unbound Medicine ER -