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Multicenter Study
. 2004 May;25(10):859-66.
doi: 10.1016/j.ehj.2004.03.004.

Relative value of N-terminal probrain natriuretic peptide, TIMI risk score, ACC/AHA prognostic classification and other risk markers in patients with non-ST-elevation acute coronary syndromes

Oscar Bazzino  1 , Juan J Fuselli, Fernando Botto, Diego Perez De Arenaza, Cecilia Bahit, Jorge Dadone; PACS group of investigators
Affiliations
Multicenter Study

Relative value of N-terminal probrain natriuretic peptide, TIMI risk score, ACC/AHA prognostic classification and other risk markers in patients with non-ST-elevation acute coronary syndromes

Oscar Bazzino et al. Eur Heart J. 2004 May.

Abstract

Aims: We prospectively studied the additive value of N-terminal probrain natriuretic peptide (NT-proBNP) in relation to the Thrombolysis in Myocardial Infarction (TIMI) risk score and the American College of Cardiology/American Heart Association (ACC/AHA) joint prognostic classification, and compared the predictive capacity of NT-proBNP, troponin T (TnT), C-reactive protein (hsCRP), myoglobin, and creatine kinase-MB (CK-MB) concentrations in a cohort of 1483 consecutive patients with non-ST-segment-elevation acute coronary syndromes (NSTE-ACS).

Methods and results: Centralised measurements of NT-proBNP, TnT, myoglobin, and hsCRP were performed 3 h (median) after admission. Adjusting by clinical, ECG variables, and biomarkers, NT-proBNP concentration was the strongest independent predictor of in-hospital (OR 1.7, 95% CI: 1.31-2.20, p < .001) and 180-day mortality (OR 1.67, 95% CI: 1.41-1.99, p < .001), and added significant prognostic information to the TIMI and ACC/AHA prognostic categories. NT-proBNP was not an independent predictor of risk of new myocardial infarction, even in the acute or long term.

Conclusions: In NSTE-ACS, NT-proBNP adds substantial information to the TIMI risk score and the ACC/AHA classification. Compared to other biomarkers, NT-proBNP is the strongest independent predictor of in-hospital and 180-day mortality.

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