doi: 10.1161/01.CIR.0000088022.53567.8C
(Circulation. 2003;108:e9004.)
© 2003 American Heart Association, Inc.
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Circulation Newswriter
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
Prognostic Significance of Markers in Combination
The combination of pro-brain natriuretic peptide (NT-proBNP) and creatinine clearance proved the predictor of prognosis in patients with acute coronary syndrome in a subset analysis of the Global Utility of Strategies To Open occluded arteries IV (GUSTO-IV) trial in this week’s issue of Circulation: Journal of the American Heart Association (Circulation. 2003;108:275–281).
In this study, NT-proBNP, troponin T, and C-reactive protein were analyzed in blood samples obtained an average of 9.5 hours from the start of symptoms in 6809 acute coronary syndrome patients in the trial. The levels of NT-proBNP were correlated with age, female gender, low body weight, diabetes, kidney failure, history of heart attack, heart failure, heart rate, ongoing heart muscle damage, and time since the onset of ischemia.
As levels of NT-proBNP increased, the researchers found that mortality rate at 1 year also increased. For example, the patients with levels of the marker in the lowest quartile had a death rate of 1.8%. In the second quartile, the death rate was 3.9%; in the third, 7.7%; and in the highest quartile, 19.2%. In fact, the researchers found that NT-proBNP had the strongest relation to 1-year mortality among the markers tested.
Troponin T, C-reactive protein, heart rate, creatinine clearance, and ST-segment depression also correlated with 1-year mortality rate. Troponin T, creatinine clearance, and ST-segment depression were the only markers to be independently related to the risk of future heart attack.
Combining NT-proBNP and creatinine clearance, however, provided the best prediction of death at 1 year. The