B-type natriuretic peptide: a strong predictor of early and late mortality in patients with acute chest pain without ST-segment elevation in the emergency department

Bassan, Roberto; Tura, Bernardo Rangel; Maisel, Alan S.

doi:10.1097/mca.0b013e3283292ac6

Cited by 28 publications

(15 citation statements)

References 47 publications

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“…The area under the ROC curve was 0.92, showing a good accuracy. This finding is in accordance with other studies in the literature, such as those by Weber et al and Bassan et al [11][12][13][14][15] , showing the statistical power and importance of natriuretic peptides as predictors of cardiac death in ACS patients.…”

Section: Discussionsupporting

confidence: 83%

“…This was not observed in the study by Bassan et al 12 , which used the BNP on admission to distinguish the cutoff point as an early and late mortality predictor. Our hypothesis is that 96-hour BNP can be a marker more compatible with the real world in the long-run, because it is the result of the therapeutic approach.…”

Section: Scotti Et Al Bnp In Acute Coronary Syndrome Prognosismentioning

confidence: 46%

“…In a recently published study aiming at analyzing the prognosis of patients with NSTE-ACS, an admission BNP cutoff point of 101 pg/ml discriminated a relative risk of death of 13.0 in the first month and of 5.3 at one year 12 .…”

Section: Scotti Et Al Bnp In Acute Coronary Syndrome Prognosismentioning

confidence: 99%

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Valor prognóstico do peptídeo natriurético tipo B na mortalidade de pacientes com Síndrome Coronariana Aguda

Scotti

Tura

Rocha

et al. 2012

Arq. Bras. Cardiol.

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Background: The prognostic value of BNP in acute coronary syndrome (ACS) has been repeatedly assessed, but not completely well established. Literature data for establishing the best time for assessing BNP, be it on hospital admission or after coronary intervention, are controversial.Objective: To analyze BNP in non-ST segment elevation ACS (NSTE-ACS) in the long term, and to assess the association between BNP (pg/ml), death, coronary anatomy, and TIMI Risk Score.Methods: Forty patients with NSTE-ACS and troponin>0.50 ng/ml had their BNP levels measured on admission and 96 hours after, and were followed up for four years. The difference between the two measures was assessed by use of Wilcoxon test (p<0.05). The ROC curve was used to evaluate 96-hour BNP accuracy as a death predictor, and logistic regression was used to assess a possible confounding factor among 96-hour BNP, age, and outcome.

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Section: Discussionsupporting

confidence: 83%

Section: Scotti Et Al Bnp In Acute Coronary Syndrome Prognosismentioning

confidence: 46%

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Valor prognóstico do peptídeo natriurético tipo B na mortalidade de pacientes com Síndrome Coronariana Aguda

Scotti

Tura

Rocha

et al. 2012

Arq. Bras. Cardiol.

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“…In patients with chest pain and ACS presenting to the ED, a higher BNP was a powerful marker for cardiac mortality. 23 Furthermore, in patients with acute decompensated HF, higher values of BNP and NT-proBNP predict mortality. 24 Finally, in a nonselected population presenting to the ED, higher NTproBNP values were related to in-hospital and long-term mortality.…”

Section: Tion Of Long-term Anticoagulation Therapy (Re-ly) and The Apmentioning

confidence: 99%

NT‐proBNP is associated with mortality and adverse cardiac events in patients with atrial fibrillation presenting to the emergency department

Holl

Bos

Domburg

et al. 2018

Clinical Cardiology

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BackgroundAtrial fibrillation (AF) is the most common cardiac arrhythmia in the emergency department. The CHA2DS2‐VASc score helps to predict thromboembolic risk; however, the rate of other adverse cardiac events is more difficult to predict.HypothesisThe biomarker N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) has prognostic value in patients presenting to the emergency department with AF.MethodsDuring a 1.5‐year period, a prospective study was performed in consecutive patients presenting to the emergency department with AF on the presenting electrocardiogram. At baseline, NT‐proBNP was measured. The primary endpoints were all‐cause death and major adverse cardiac events (MACE: all‐cause mortality, myocardial infarction, or revascularization).ResultsA total of 355 patients were included (mean age, 71 years; 55% male). The median duration of follow‐up was 2 years. After adjustment for baseline variables, the logNT‐proBNP was independently correlated with death (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.18‐1.99) and MACE (HR: 1.27, 95% CI: 1.03‐1.58). After adjustment for baseline variables, a high NT‐proBNP value (>500 pmol/L) was independently correlated with death (HR: 2.26, 95% CI: 1.19‐4.28), and for MACE a trend was seen (HR: 1.67, 95% CI: 0.96‐2.91) compared with a low value (<250 pmol/L).ConclusionsIn patients presenting to the emergency department with AF, higher NT‐proBNP values are independently associated with an increased mortality and MACE. Therefore, this biomarker may be a useful prognostic marker in the management and treatment of these patients.

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“…18-22 In 1 study, patients with BNP >101 pg/ml had a 13-fold higher rate of 1-month mortality (P<0.0001) and a 5.3-fold higher rate of 1-year mortality (P<0.0001) than patients with BNP ≤101 pg/ml. 22 In another study by Darbar et al, BNP was the only independent predictor of cardiovascular mortality in patients with acute MI. 23 Khan et al were able to show that NT-proBNP predicted death after acute MI better than TIMI risk score.…”

Section: Prognostic Value Of Nt-probnp In Patients With Acsmentioning

confidence: 99%

Prognostic Value of N-Terminal pro-B-Type Natriuretic Peptide in Patients With Acute Coronary Syndromes Undergoing Left Main Percutaneous Coronary Intervention

Jaberg¹,

Toggweiler²,

Puck³

et al. 2011

Circ J

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Background: Patients undergoing acute left main (LM) coronary artery revascularization have a high mortality and natriuretic peptides such as N-terminal pro-B-type (NT-proBNP) have been shown to have prognostic value in patients with acute coronary syndromes. The present study looked at the prognostic value of NT-proBNP in these patients. Methods and Results:We studied all consecutive patients undergoing acute LM coronary artery percutaneous coronary intervention between January 2005 and December 2008 in whom NT-proBNP was measured (n=71). We analyzed the clinical characteristics and the short- and long-term outcomes in relation to NT-proBNP level at admission. Median NT-proBNP was 1,364 ng/L, ranging from 46 to 70,000 ng/L. NT-proBNP was elevated in 63 (89%) patients and was ≥1,000 ng/L in 42 (59%). Log NT-proBNP (hazard ratio [HR] 3.51, 95% confidence interval [CI] 1.55-7.97, P=0.003) and left ventricular ejection fraction (HR 0.95, 95%CI 0.91-0.99, P=0.007) were predictors for all-cause mortality. Log NT-proBNP was the only independent significant predictor of cardiovascular mortality. In-hospital mortality was 0% for patients with NT-proBNP <1,000, but 17% for those with NT-proBNP ≥1,000 (P= 0.036). Conclusions:NT-proBNP is a strong predictor of outcome in patients undergoing acute LM coronary artery stenting. Mortality in such patients is high, but those with NT-proBNP <1,000 ng/L may have a favorable short- and longterm prognosis. Further research, including a larger patient population, is needed to determine the optimal cut-off value for NT-proBNP in patients undergoing acute LM coronary artery intervention. (Circ J 2011; 75: 2648 - 2653

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B-type natriuretic peptide: a strong predictor of early and late mortality in patients with acute chest pain without ST-segment elevation in the emergency department

Abstract: Admission BNP is an independent and powerful marker of early and late cardiac mortality in patients with acute chest pain without ST-segment elevation. These results suggest that BNP should be measured upon arrival at the emergency department for risk stratification in all these patients.

Cited by 28 publications

References 47 publications

Valor prognóstico do peptídeo natriurético tipo B na mortalidade de pacientes com Síndrome Coronariana Aguda

Valor prognóstico do peptídeo natriurético tipo B na mortalidade de pacientes com Síndrome Coronariana Aguda

NT‐proBNP is associated with mortality and adverse cardiac events in patients with atrial fibrillation presenting to the emergency department

Prognostic Value of N-Terminal pro-B-Type Natriuretic Peptide in Patients With Acute Coronary Syndromes Undergoing Left Main Percutaneous Coronary Intervention

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