Two Markers a Sign of Risk in Acute Coronary Syndrome

High levels of two chemicals should flag patients for more aggressive treatment

WEDNESDAY, Sept. 13 (HealthDay News) -- High levels of two biomarkers -- troponin-T and N-terminal pro-B-type natriuretic peptide (NT-proBNP) -- can help in the process of risk stratification for patients with non-ST-segment elevation acute coronary syndromes (ACS), according to a study published in the Sept. 19 issue of the Journal of the American College of Cardiology.

Stefan K. James, M.D., Ph.D., of the Academic Hospital, Uppsala, Sweden, and colleagues analyzed data on 2,340 patients with non-ST-segment elevation ACS who underwent coronary revascularization. Among 30-day survivors of the procedure, one-year mortality was calculated and stratified by levels of biomarkers as well as by status of revascularization.

There was an association between elevated levels of troponin-T or NT-proBNP biomarkers and high mortality. However, when one or both of the biomarkers were elevated, there was a lower rate of mortality following revascularization, suggesting a greater benefit for such patients. Those without elevated levels of the two markers had relatively low one-year mortality and no reduction in risk after revascularization. Such patients actually had a significant increase in one-year mortality after revascularization.

"In centers where early revascularization can be performed with low procedural mortality, patients with elevated levels of both markers are at high risk of death that appears to be reduced by coronary revascularization," the authors concluded. "Measurement of troponin-T and NT-pro-BNP levels should be included in risk stratification and early management strategy decisions for patients with ACS."

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