title: Relative value of N-terminal probrain natriuretic peptide, TIMI risk score, ACC/AHA prognostic classification and other risk markers in patients with non-ST-elevation acute coronary syndromes.
abstract: OBJECTIVE
  We prospectively studied the additive value of N-terminal probrain natriuretic peptide (NT-proBNP) in relation to the Thrombolysis in Myocardial Infarction (TIMI) risk score and the American College of Cardiology/American Heart Association (ACC/AHA) joint prognostic classification, and compared the predictive capacity of NT-proBNP, troponin T (TnT), C-reactive protein (hsCRP), myoglobin, and creatine kinase-MB (CK-MB) concentrations in a cohort of 1483 consecutive patients with non-ST-segment-elevation acute coronary syndromes (NSTE-ACS).
  
  
  RESULTS
  Centralised measurements of NT-proBNP, TnT, myoglobin, and hsCRP were performed 3 h (median) after admission. Adjusting by clinical, ECG variables, and biomarkers, NT-proBNP concentration was the strongest independent predictor of in-hospital (OR 1.7, 95% CI: 1.31-2.20, p < .001) and 180-day mortality (OR 1.67, 95% CI: 1.41-1.99, p < .001), and added significant prognostic information to the TIMI and ACC/AHA prognostic categories. NT-proBNP was not an independent predictor of risk of new myocardial infarction, even in the acute or long term.
  
  
  CONCLUSIONS
  In NSTE-ACS, NT-proBNP adds substantial information to the TIMI risk score and the ACC/AHA classification. Compared to other biomarkers, NT-proBNP is the strongest independent predictor of in-hospital and 180-day mortality.
authors.affiliation: Department of Cardiology, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. oscar.bazzino@hospitaliano.org.ar
authors.forename: Oscar
authors.initials: O
authors.lastname: Bazzino
authors.forename: Juan J
authors.initials: JJ
authors.lastname: Fuselli
authors.forename: Fernando
authors.initials: F
authors.lastname: Botto
authors.forename: Diego
authors.initials: D
authors.lastname: Perez De Arenaza
authors.forename: Cecilia
authors.initials: C
authors.lastname: Bahit
authors.forename: Jorge
authors.initials: J
authors.lastname: Dadone
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood*; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D011379:Prognosis; D011446:Prospective Studies; D012044:Regression Analysis; D012307:Risk Factors; D013997:Time Factors
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain