Admission B-type natriuretic peptide assessment improves early risk stratification by Killip classes and TIMI risk score in patients with acute ST elevation myocardial infarction treated with primary angioplasty

Grabowski, Marcin; Filipiak‬, Krzysztof J.; Małek, Łukasz A.; Karpiński, Grzegorz; Huczek, Zenon; Stolarz, Przemysław; Śpiewak, Mateusz; Kochman, Janusz; Rudowski, Robert; Opolski, Grzegorz

doi:10.1016/j.ijcard.2006.04.038

Cited by 45 publications

(32 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our results (with a larger patient population) are consistent with those of Bazzino et al, who showed that baseline NT-proBNP is an important prognostic variable in non-ST-elevation ACS and Grabowski et al, in patients with ST-elevation MI treated with primary angioplasty (this last study with BNP) (15,16). The results were also consistent with those of Galvani et al that compared the whole spectrum of ACS as our study (13).…”

Section: Discussionsupporting

confidence: 92%

Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes?

et al. 2009

View full text Add to dashboard Cite

Background: NT-proBNP has prognostic implications in heart failure. In acute coronary syndromes (ACS) setting, the prognostic significance of NT-proBNP is being sought. We studied short-term prognostic impact of admission NT-proBNP in patients admitted for ACS and in association with GRACE risk score (GRS). Methods and Results: We studied 1035 patients admitted with ACS. Patients were divided in quartiles according to NT-proBNP levels on admission: Q1 B180 pg/ ml; Q2 180Á691 pg/ml; Q3 696Á2664 pg/ml; Q4 2698Á35 000 pg/ml. Groups were compared in terms of short-term allcause mortality. Patients with higher NT-proBNP had worst GRS on admission. They also received less aggressive treatment. In-hospital mortality was 0.8%, 3.0%, 5.8% and 12.8% (P B0.001) and 30-day mortality 1.6%, 4.6%, 6.5% and 16.7% (P B0.001) respectively. In multivariate logistic regression analysis, NT-proBNP is an independent predictor of inhospital (OR 2.35; 95% CI: 1.12Á4.93, P 00.022) and 30-day mortality (OR 2.20; 95% CI: 1.17Á4.12, P 00.014). However, NT-proBNP does not add any incremental benefit to GRS for prediction of outcome by ROC curve analysis. Conclusions: NT-proBNP is an independent predictor of in-hospital and 30-day mortality after ACS, independently of left ventricular function, but does not increase the prognostic accuracy of GRS.

show abstract

Section: Discussionsupporting

confidence: 92%

Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes?

et al. 2009

View full text Add to dashboard Cite

show abstract

“…When the GRACE score was compared with BNP the two were found to provide complementary information [25]. BNP also provides incremental prognostic information over and above the TIMI score in STEMI patients treated with primary angioplasty [26,27]. Similarly NT-proBNP is able to provide prognostic information in NSTEMI patients over and above the TIMI score [28].…”

Section: Grace Score and Nt-probnp -6-month Mortalitymentioning

confidence: 99%

N-terminal pro-B-type natriuretic peptide complements the GRACE risk score in predicting early and late mortality following acute coronary syndrome

Khan

Narayan

et al. 2009

Clinical Science

View full text Add to dashboard Cite

Background: The GRACE risk score has been shown to offer predictive power with regards to death and myocardial infarction (AMI) in patients with acute coronary syndromes (ACS). Nterminal pro-B type natriuretic peptide (NT-proBNP) has also been found to be useful in predicting mortality following ACS. Aim: We sought to investigate the utility of GRACE score and NT-proBNP levels at predicting risk of early and late deaths following ACS. Method: We studied 1033 patients (740 men, mean age 66.5 ± 12.7years) with AMI. Blood was drawn once within 24 hours following the onset of chest pain. The plasma concentration of NT-proBNP was determined using an in-house non-competitive immunoassay. Results: Patients were GRACE risk scored as described. 30-day mortality was 3.7%, 6-month mortality was 7.8%, all were related to higher GRACE risk scores (p=0.001 for trend). Higher NT-proBNP levels were also related to increased mortality (p<0.0001). In a Cox proportional hazards model, independent predictors of 30-day and 6-month mortality included NT-proBNP levels and GRACE risk score. The receiver-operating curve for GRACE risk score was complemented by NT-proBNP levels for prediction of 30-day mortality (AUC 0.85) and 6-month mortality (AUC 0.81). Conclusion: NT-proBNP gives complementary information to GRACE risk score for predicting early and late mortality. The inclusion of the NT-proBNP blood test is useful in risk stratifying patients after an acute coronary syndrome.

show abstract

“…Furthermore, their multiple regression analysis revealed that BNP was the only dependent factor that was correlated with MI size, which was also confirmed in the present study. Nijveldt et al (2008) reported that BNP was more strongly correlated with necrotic cardiac muscles than with ischemic cardiac muscles, and Grabowski et al (2007) reported that BNP was more informative than other clinical indexes, such as the Killip grade, TIMI risk points, etc. Mayr et al (2011) found that the NT-proBNP concentration was closely correlated with heart function and could accurately predict chronic MI size after 3 days of MI, and that the heart function of the patients could not recover if the NT-proBNP level was >1115 pg/mL.…”

Section: Discussionmentioning

confidence: 99%

Association of plasma B-type natriuretic peptide concentration with myocardial infarct size in patients with acute myocardial infarction

Niu¹,

Ma²,

Xie³

et al. 2014

Genet. Mol. Res.

View full text Add to dashboard Cite

ABSTRACT. B-type natriuretic peptide (BNP) is widely used in the treatment of early-stage heart failure and coronary heart disease. In this study, the association of plasma BNP concentration with myocardial infarct (MI) size in patients with acute myocardial infarction (AMI) was investigated. Eighty patients with AMI were enrolled in the MI group and 30 healthy volunteers were selected as the control group. Magnetic resonance imaging of the heart and plasma BNP concentration detection were carried out, and then the relationship between plasma BNP concentration and MI size was analyzed in the two groups. Results showed that the plasma BNP concentration was positively related to MI size (r = 0.645, P < 0.0005), whereas it was negatively correlated to the left ventriculus ejection fraction (r = 0.297, P = 0.047). Multiple regression analysis showed that MI size was the only parameter that was independently associated with BNP (r 2 = 0.32, F = 7.712, P = 0.007). Moreover, when the BNP level reached 150 pg/mL, it had 85.1% sensitivity and 70.4% specificity of determining MI sizes exceeding 10%. The plasma concentration of BNP is highly related to MI size in patients with AMI, and can be clinically used to evaluate MI size.

show abstract

Admission B-type natriuretic peptide assessment improves early risk stratification by Killip classes and TIMI risk score in patients with acute ST elevation myocardial infarction treated with primary angioplasty

Cited by 45 publications

References 23 publications

Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes?

Does admission NT-proBNP increase the prognostic accuracy of GRACE risk score in the prediction of short-term mortality after acute coronary syndromes?

N-terminal pro-B-type natriuretic peptide complements the GRACE risk score in predicting early and late mortality following acute coronary syndrome

Association of plasma B-type natriuretic peptide concentration with myocardial infarct size in patients with acute myocardial infarction

Contact Info

Product

Resources

About