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More Use of BNP Test in Heart Patients May Be Warranted

Approximately 20 percent of patients with acute coronary syndrome received test in hospital

WEDNESDAY, Dec. 19 (HealthDay News) -- In a national sample, B-type natriuretic peptide (BNP) levels were measured in only one-fifth of patients with non-ST-segment-elevation acute coronary syndromes (NSTE ACS), even though elevated levels are associated with higher mortality risk in these patients, according to research published in the Dec. 15 issue of the American Journal of Cardiology.

Brett D. Atwater, M.D., of the University of Wisconsin-Madison, and colleagues analyzed data from 77,071 patients with NSTE ACS treated at 486 hospitals between February 2003 and September 2006.

The investigators found that BNP was measured in 21.2 of patients, but the rate of measurement per quarter rose from 5.1 percent to 27.7 during the analysis. Factors associated with measurement include signs of heart failure at presentation, older age, previous heart failure and faster presenting heart rate. Higher BNP elevation was associated with incrementally higher mortality rates in the hospital in low-, moderate- and high-risk patients.

"Although elevated BNP levels identify patients with a higher risk for mortality, the greatest utility of BNP measurement may ultimately derive from how the results are used to guide therapeutic decision making for patients with NSTE ACS. Other risk stratification tools, such as elevated cardiac troponin levels, have been shown to identify higher-risk patients with NSTE ACS who derive enhanced benefit from guideline-recommended therapies, including glycoprotein IIb/IIIa inhibitors and early invasive management strategies," the authors write.

Several of the study's co-authors have financial ties to pharmaceutical companies.

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