Serial analyses of N-terminal pro-B-type natriuretic peptide in patients with non–ST-segment elevation acute coronary syndromes

Lindahl, Bertil; Lindbäck, Johan; Jernberg, Tomas; Johnston, Nina; Stridsberg, Mats; Venge, Per; Wallentin, Lars

doi:10.1016/j.jacc.2004.10.057

Cited by 112 publications

(87 citation statements)

References 35 publications

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“…Hess et al (2005b) suggested that in the elderly population, a cut-off level of 125 pg/ml (14.75 pmol/L; 1 pg/ml = 0.118 pmol/L) is useful either to exclude cardiac dysfunction in symptomatic individuals or to risk stratify elderly individuals in terms of the necessity for intervention. Thus, our subjects were classified into these groups according to their NT-proBNP levels, and there was higher number of patients (> 70.0% of all examinees) in group 2 (levels of NT-proBNP higher than 14.75 pmol/L) as expected, since it was shown in earlier studies that patients with NSTE-ACS have elevated levels of NTproBNP (Sabatine et al, 2002;Lindahl et al, 2005;Jernberg et al, 2004;Heeschen and Hamm, 2004). It was also suggested that the NT-proBNP level increases with the level of symptoms as assessed by New York Heart Association (NYHA) classification and the level of impaired left ventricular dysfunction as assessed by echocardiography (Bay et al, 2003;Pfister et al, 2004;Hess et al, 2005a;Drewniak et al, 2008;Kaski et al, 2010).…”

Section: Discussionmentioning

confidence: 63%

“…Levels of NT-proBNP showed downward trend over time (months) in some other studies (Gill et al, 2004;Eggers et al, 2009). Lindahl et al (2005) took patients' blood samples at baseline, day 2, 6 weeks, 3 months, and 6 months, and NT-proBNP levels were found to decrease throughout the whole sampling period, rapidly in the early phase followed by a more gradual decline.…”

Section: Levels Of Acs Biomarkersmentioning

confidence: 99%

“…Ischemia and myocardial damage cause transient and permanent increase in wall tension and myocardial stretch (Lindahl et al, 2005). Brain (B-type) natriuretic peptide (BNP) and its more stable counterpart N-terminal pro-BNP (NT-proBNP) (Mueller et al, 2004) are synthesized in ventricular myocardium and released into the circulation in response to ventricular dilatation and pressure overload Hall, 2004).…”

Section: Introductionmentioning

confidence: 99%

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Prognostic value of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes

Medjedovic¹

2012

Afr. J. Pharm. Pharmacol.

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The aim of this study was to compare the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other frequently used biomarkers, such as creatine kinase (CK), creatine kinase-mB (CK-MB), cardiac troponin T (cTnT) and C-reactive protein (CRP) for systolic and diastolic left ventricular function (SLVF and DLVF), and adverse coronary events in patients with non-ST-segment elevation acute coronary syndrome. The research was carried out within a group of 75 patients. Patients with referent NT-proBNP levels (<14.75 pmol/l) had significantly less compromised SLVF as compared to patients with elevated NT-proBNP levels. Initially determined levels of NT-proBNP showed statistically significant correlations with all parameters of left ventricular function measured on the control examination, while other biomarkers, except creatine kinase, did not. High sensitivity and negative predictive value of NT-proBNP for SLVF (up to 95.1 and 88.9%, respectively) and adverse coronary events (up to 100.0%) was found. These results make us assume that NT-proBNP may be the single best predictor of left ventricular function in patients with non-ST-segment elevation acute coronary syndromes.

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Section: Discussionmentioning

confidence: 63%

Section: Levels Of Acs Biomarkersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prognostic value of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes

Medjedovic¹

2012

Afr. J. Pharm. Pharmacol.

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“…Akut koroner sendromlu hastalarda NT-pro-BNP düzeylerinin başlangıçtaki hızlı azalmadan sonra en az 6 ay boyunca azalmaya devam ettiği gösterilmiştir. Akut miyokart enfarktüs sonrası takip eden süreçte NT-pro-BNP düzeylerindeki düşmenin daha yavaş olmasının, sol ventrikül sistolik fonksiyonundaki kronik bozulmayla ilişkili olduğu öne sürülmüştür (20). Kardiyak resenkronizasyon tedavisi yapılan hastalarda, NT-pro-BNP düzeylerinin erkenden azalmaya başlaması ve bu azalmanın devam etmesinin, tedavinin etkinliğini yansıtabileceği bildirilmiştir (21).…”

Section: Discussionunclassified

Relationship between coronary collateral circulation and plasma levels of N-terminal pro-B-type natriuretic peptide

Kadı

Ceyhan²,

Çelik³

et al. 2011

Anadolu Kardiyol Derg

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Objective: There have been numerous investigations demonstrating protective effects of awell-grown coronary collateral circulation (CCC) on left ventricular systolic function. N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) is released by ventricular myocardium as a result of increased myocardial wall stress. The aim of the study was to evaluate the relationship between CCC and plasma NT-pro-BNP levels. Methods: Study group was retrospectively selected from patients who had a coronary angiography at our center between January 2008 and December 2009. One hundred and thirty patients having at least one totally occluded main coronary artery were included in this study. Collateral circulation was graded according to Rentrop score. Grade 0 and 1 are regarded as poor, and grade 2 and 3 -good CCC. Plasma NT-pro-BNP levels were measured by electrochemiluminescence immunoassay method and left ventricular ejection fraction (LVEF) were measured by modified Simpson method. We used Chi-square, Student t and Mann-Whitney-U tests for statistical analysis. Results: Overall 57 patients were found to have poor CCC and 73 patients have good CCC. Plasma NT-pro-BNP levels (pg/ml)-median (minimummaximum)-were 1319 (48-9753) in poor CCC group and 847 (16-5529) in good CCC group (p=0.004). LVEF was found to be -median (minimummaximum)-45% (30-55%) in poor CCC group and 50% (30-60%) in good CCC group (p=0.003). Correlation analysis demonstrated that collateral grade was negatively correlated with NT-pro-BNP levels (r=-0.252, p=0.004). 29

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“…However, the natriuretic peptides might also rise in response to a number of other stimuli, among them ischemia per se and cytokines [30,31]. BNP and NT-proBNP have received widespread use for diagnosis of heart failure and evaluation of acute dyspnea.…”

Section: The B-type Natriuretic Peptidementioning

confidence: 99%

Acute coronary syndrome – the present and future role of biomarkers1)

Lindahl¹

2013

Clinical Chemistry and Laboratory Medicine

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Over the past two decades there have been dramatic changes in the diagnosis, treatment and prognosis of acute coronary syndrome (ACS). Several new treatment modalities have been added and the prognosis has improved dramatically. Biomarkers play a crucial role in the management of ACS. At present, cardiac troponin is the biomarker of choice for diagnosis of acute myocardial infarction (AMI). Currently, there are no other biomarkers, which can compete, neither regarding specificity nor regarding early sensitivity. However, there is still a clinical need of a biomarker able to reliably rule-in or rule-out AMI immediately on admission. MicroRNAs seem to be promising new candidates for diagnostic purposes. The optimal combination of biomarkers and new imaging techniques is another important area for research. The list of biomarkers associated with an adverse prognosis in ACS is long. However, for most of them it has been very difficult to prove an added clinical value. Only cardiac troponin, and to some degree also B-type natriuretic peptides, is widely used in clinical practice for risk assessment. Among new markers, growth differentiation factor 15 and the midregional part of the prohormone of adrenomedullin, have shown some promising results. Since the renal function is assessed in clinical routine, also markers of the renal function have gained increasing interest. Cardiac troponin has been proven useful for selection of antithrombotic, antiplatelet and invasive treatment. Besides cardiac troponin, no other markers have consistently been shown to be useful for selection of specific treatments.

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Serial analyses of N-terminal pro-B-type natriuretic peptide in patients with non–ST-segment elevation acute coronary syndromes

Cited by 112 publications

References 35 publications

Prognostic value of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes

Prognostic value of N-terminal pro-B-type natriuretic peptide in patients with non-ST-segment elevation acute coronary syndromes

Relationship between coronary collateral circulation and plasma levels of N-terminal pro-B-type natriuretic peptide

Acute coronary syndrome – the present and future role of biomarkers1)

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