N-terminal Prob B Type Natriuretic Peptide. A predictor of Adverse outcome in Coronary Syndrome Patients without ST- Segment Elevation

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Abstract

Background

Brain natriuretic peptide (BNP) is a strong predictor of adverse outcome in patients with acute coronary syndromes. Therefore, it is expected that N terminal pro B type natriuretic peptide (NT Pro-BNP) should be a useful early risk stratification marker in this setting. 

Research Design and Methods 

We measured NT pro-BNP, troponin T, CK-MB mass, C reactive protein and myoglobin in serum samples obtained from 254 patients enrolled in a prospective multicentric cohort of non ST-segment elevation coronary syndrome patients. Primary end point was 30-day mortality. 

Results

The overall 30-day mortality rate was 3.8%. NT pro-BNP leves were measured in samples obtained at a median time  of 4.9 hours (from admission) and at a median time of 12 hours. NT Pro-BNP concentration was significantly lower in patients who survived (392.5 pg/ml) than in those who died (2706 pg/ml), p=0.003. Stepwise logistic regression analysis including significant predictors (ST deviation and elevated markers)  showed that both admission NT Pro-BNP levels (OR 5 [95% C: 1-24.9]  p=0,04) and 12 hs NT Pro-BNP leves (OR 3.4 [95% CI: 1.1-9.7] p=0.02) were independent predictors of 30-day mortality.