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Risk stratification in acute coronary syndromes without ST elevation (UA/NSTEMI) is essential in determining the therapeutic strategy. The NT-proBNP is a marker of ventricular dysfunction. In the setting of UA/NSTEMI, expression of NT-ProBNP may be related to the tissue at risk and be a good predictor of major cardiovascular events.
To determine the prognostic value of NT pro-BNP in relation to cardiovascular events in the initial stratification of UA/NSTEMI.
Between May 2009 and December 2011, 598 patients were admitted to the coronary care unit with UA/NSTEMI. NT-Pro BNP levels were measured using a commercially available immunoassay. The prognostic cutoff value of NT-proBNP was established by ROC curve analysis.
By ROC curve analysis we obtained a cutoff value of NT pro-BNP of 1329 pg/ml for major cardiovascular events. Of the 598 enrolled patients, 346 patients (57%) had a NT proBNP value < 1329 pg/ml and 252 (43%) a level > 1329 pg/ml. The combined endpoint of heart failure, stroke and death was more frequent in patients with NT proBNP value > 1329 pg/ml (8% vs. 2.4%; p = 0.001). Important to note that a significant proportion of patients with NT-proBNP > 1329 could have been considered of low risk by traditional markers; 148 patients (59%) were in Killip 1 class, 47 patients (18.6%) had negative troponin, and 25 patients (10%) had low risk by TIMI score.
The elevation of NT pro-BNP on admission is an important predictor of short-term major cardiovascular events.
Poster Sessions, Expo North
Sunday, March 10, 2013, 3:45 p.m.-4:30 p.m.
Session Title: The Blood Tells a Story: Coeptin, Fatty Acid Binding Protein, NT-Pro BNP and More
Abstract Category: 1. Acute Coronary Syndromes: Clinical
Presentation Number: 1259-211
- 2013 American College of Cardiology Foundation