The prognostic value of NT-proBNP, Troponin I, and hs-CRP in patients with acute coronary syndrome / 대한내과학회지
Korean Journal of Medicine
;
: 200-210, 2009.
Article
Dans Coréen
| WPRIM
| ID: wpr-17468
ABSTRACT
BACKGROUND/AIMS:
Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), troponin I, and high-sensitivity C-reactive protein (hs-CRP) are each associated with higher rates of death and recurrent myocardial ischemia in patients with acute coronary syndrome (ACS). We evaluated the prognostic value of NT-proBNP and a multi-marker risk approach with the simultaneous assessment of NT-proBNP, troponin I, and hs-CRP in patients with ACS.METHODS:
We included 277 patients who were admitted for ACS between January and December 2006. We measured NT-proBNP, troponin I, and hs-CRP within 24 hours of the onset of symptoms. Patients were followed for a median of 559 days for cardiovascular events, including death, new myocardial infarction, heart failure, or rehospitalization for ACS.RESULTS:
NT-proBNP was the most powerful predictor of clinical outcome among the biomarkers (HR 3.65, 95% CI 2.11-6.30), followed by the peak troponin I and hs-CRP (HR 2.08, 95% CI 1.12-3.87;HR 1.99, 95% CI 1.18-3.37, respectively), but not the baseline troponin I. A multi-marker risk approach with the simultaneous assessment of NT-proBNP, hs-CRP, and peak troponin I was significantly associated with cardiovascular events, especially the presence of three positive biomarkers (adjusted HR 4.20, 95% CI 1.39-12.67).CONCLUSIONS:
NT-proBNP is the most powerful, independent predictor of clinical outcome among the cardiac biomarkers. Since the peak troponin I level provides more prognostic information than the baseline level, follow-up measurement of troponin I may be warranted for risk stratification. The multi-marker risk approach appears to have better prognostic performance than any marker in isolation.
Texte intégral:
Disponible
Indice:
WPRIM (Pacifique occidental)
Sujet Principal:
Fragments peptidiques
/
Pronostic
/
Troponine
/
Protéine C-réactive
/
Marqueurs biologiques
/
Études de suivi
/
Ischémie myocardique
/
Troponine I
/
Peptide natriurétique cérébral
/
Syndrome coronarien aigu
Type d'étude:
Étude observationnelle
/
Étude pronostique
/
Facteurs de risque
Limites du sujet:
Humains
langue:
Coréen
Texte intégral:
Korean Journal of Medicine
Année:
2009
Type:
Article
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