NT-ProBNP in non-ST-elevation acute coronary syndrome

Abstract

Background: The role of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the early treatment of patients with non-ST-elevation acute coronary syndrome (NSTACS) has been evaluated in 6 large studies that include >12,000 patients.

Methods and results: These studies convincingly show that this marker of cardiac performance is associated strongly with death and the risk of future congestive heart failure and carry important prognostic information that is independent from previous known risk factors in NSTACS. As such, NT-proBNP can be added to existing risk stratification models and multimarker approaches. There is some data that indicate that this marker might also be helpful in guiding decisions about coronary revascularization in these patients, but further studies are needed.

Conclusion: Before routine use of NT-proBNP in NSTACS, the extra cost of adding this new marker to the current routine markers and its impact on selection of treatment should be considered.