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.
Artigo
em Coreano
| 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.
Texto completo:
DisponíveL
Índice:
WPRIM (Pacífico Ocidental)
Assunto principal:
Fragmentos de Peptídeos
/
Prognóstico
/
Troponina
/
Proteína C-Reativa
/
Biomarcadores
/
Seguimentos
/
Isquemia Miocárdica
/
Troponina I
/
Peptídeo Natriurético Encefálico
/
Síndrome Coronariana Aguda
Tipo de estudo:
Estudo observacional
/
Estudo prognóstico
/
Fatores de risco
Limite:
Humanos
Idioma:
Coreano
Revista:
Korean Journal of Medicine
Ano de publicação:
2009
Tipo de documento:
Artigo
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