J Korean Soc Emerg Med.  2008 Feb;19(1):65-73.

Availability of Bedside N-terminal Pro-Brain Natriuretic Peptide Measurement as Prognostic Marker About Development of Major Adverse Cardiovascular Events in Patients of Acute Coronary Syndromes

Affiliations
  • 1Department of Emergency Medicine, Inje University Ilsan Paik Hospital, Gyeonggi-Do, Korea. dwshin@ilsanpaik.ac.kr

Abstract

PURPOSE: Natriuretic peptide levels are known to be associated with cardiac output and ventricular function. Recently it has been suggested that N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is available as a prognostic marker for acute coronary syndrome patients. We compared NTpro- BNP levels between patients with and without major adverse cardiovascular events (MACEs) who visited the emergency room due to acute coronary syndrome.
METHODS
We designed a case-only study with study subjects recruited retrospectively by medical chart review. Patients who visited the emergency room from 1 May 2006 to 31 February 2007 and were diagnosed with acute coronary syndrome were enrolled. Subjects who did not receive bedside measurement of NT-proBNP levels were excluded. To analyze by subtype of acute coronary syndrome, we classified study subjects into the following group: ST elevation myocardial infarction, non-ST elevation myocardial infarction, or unstable angina.
RESULTS
The level of NT-proBNP was 2,592+/-917 pg/ml in MACEs patients, and 1,289+/-1,261 pg/ml in patients without MACEs, a statistically significant difference (p<0.0001). The MACEs patients showed higher level of NT-proBNP than patients without MACEs in the ST elevation myocardial infarction group (p=0.439), the non-ST elevation myocardial infarction group (p=0.004), and the unstable angina group (p=0.009).
CONCLUSION
Initial bedside NT-pro-BNP levels are higher in MACEs patients. Although the study size was small and the result should be carefully interpreted, it supports the hypothesis that NT-pro-BNP can as a marker to evaluate MACEs in acute coronary syndrome.

Keyword

Pro-brain natriuretic peptide; Complications; Biologic markers

MeSH Terms

Acute Coronary Syndrome
Angina, Unstable
Biomarkers
Cardiac Output
Emergencies
Humans
Myocardial Infarction
Natriuretic Peptide, Brain
Peptide Fragments
Retrospective Studies
Ventricular Function
Natriuretic Peptide, Brain
Peptide Fragments
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