title: Risk assessment in patients with unstable angina/non-ST-elevation myocardial infarction and normal N-terminal pro-brain natriuretic peptide levels by N-terminal pro-atrial natriuretic peptide.
abstract: OBJECTIVE
  To compare the accuracy of the N-terminal fragment of its pro-hormone (Nt-proBNP) and N-terminal pro-atrial natriuretic peptide (Nt-proANP) in the prediction of the 2 year mortality and to investigate whether additional measurement of Nt-proANP to troponin I (TnI) could improve risk assessment in the subgroups of patients with unstable coronary artery disease (UCAD) and normal Nt-proBNP.
  
  
  RESULTS
  Plasma levels of the TnI, Nt-proANP, and Nt-proBNP were determined in 120 consecutive patients with UCAD without ST-segment elevations and normal left ventricular function. In multivariable logistic regression analysis, TnI and Nt-proBNP were independent predictors of mortality (P=0.01 and P=0.02, respectively). However, in the group of patients with normal Nt-proBNP levels, only Nt-proANP and TnI were independently associated with mortality (P=0.007 and P=0.03, respectively). Accordingly, patients with elevated Nt-proANP levels in this group of patients had significantly higher mortality rate than patients with normal Nt-proANP levels (P=0.003).
  
  
  CONCLUSIONS
  Our results suggest that determination of Nt-proANP might improve risk assessment in patients with UCAD, especially when Nt-proBNP is in the normal range.
authors.affiliation: Third Department of Medicine (Cardiology and Emergency Medicine), Wilhelminen Hospital Vienna, Montleartstrasse 37, A-1171 Vienna, Austria.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Jarai
authors.forename: Nelly
authors.initials: N
authors.lastname: Iordanova
authors.forename: Robert
authors.initials: R
authors.lastname: Jarai
authors.forename: Annamaria
authors.initials: A
authors.lastname: Raffetseder
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Woloszczuk
authors.forename: Mariann
authors.initials: M
authors.lastname: Gyöngyösi
authors.forename: Georg
authors.initials: G
authors.lastname: Geyer
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000097:blood / Q000401:mortality*; D009320:Atrial Natriuretic Factor / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011498:Protein Precursors / Q000097:blood*; D012044:Regression Analysis; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D018709:Statistics, Nonparametric; D019210:Troponin I / Q000097:blood
chemical_list: C099254:N-terminal proatrial natriuretic peptide; D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; D011498:Protein Precursors; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor