Biomarkers Assessed in Acute Coronary Syndrome

NT-proBNP independently predicted risk in non-ST-segment elevation acute coronary syndrome

WEDNESDAY, July 15 (HealthDay News) -- N-terminal pro-brain natriuretic peptide (NT-proBNP) may be useful in predicting outcomes during early follow-up of patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), according to research published in the July 21 Journal of the American College of Cardiology.

Kai M. Eggers, M.D., of the Uppsala University Hospital in Sweden, and colleagues analyzed data from 877 patients with NSTE-ACS who participated in a trial in which they were randomized to an early invasive or noninvasive strategy and to treatment with dalteparin or placebo. Several biomarkers were measured at randomization, six weeks, and six months for their prognostic value during the five-year follow-up.

NT-proBNP was the strongest predictor for mortality out of the biomarkers measured at randomization (adjusted hazard ratio, 1.7). At six weeks and six months, this biomarker also showed the strongest association for the end point of death or myocardial infarction (adjusted hazard ratios, 1.5 and 1.4, respectively).

"Cardiac troponin I, NT-proBNP, and C-reactive protein exhibit different and changing relations to adverse events in patients with NSTE-ACS, both in the acute phase and after clinical stabilization. The NT-proBNP was independently predictive for adverse outcome throughout the entire six-month observation period and should be considered for improvement of risk stratification during early follow-up," the authors write.

Two co-authors reported financial relationships with several companies including Beckman Coulter Inc., which provided reagents for the troponin I assay.

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