title: Release pattern of N-terminal pro B-type natriuretic peptide (NT-proBNP) in acute coronary syndromes.
abstract: BACKGROUND
  Recently it has been found that BNP and NT-proBNP provide independent prognostic information in patients with acute coronary syndromes (ACS). However, little data are available on the time course of NT-proBNP levels in relation to onset of symptoms.
  
  
  RESULTS
  We included 765 patients (236 females, aged 64 +/- 11 years) with an ACS (STEMI 42%, NSTEMI 41%, UAP 17%), who were referred for coronary angiography. NT-proBNP was assessed on admission and the next day. NT-proBNP values were related to the time duration from onset of symptoms until blood drawing with lowest values within 3 h and highest values 24-36 h after onset of symptoms (147 (64-436) pg/ml and 1099 (293-3795) pg/ml, respectively, p < 0.001). Highest values for NT-proBNP on admission were found in patients with NSTEMI compared to patients with STEMI and UAP (912 (310-2258) pg/ml) vs 262 (85-1282) pg/ml) vs 182 (74- 410) pg/ml; p < 0.001), but no difference was present between STEMI and NSTEMI the day after admission (1325 (532-2974) pg/ ml vs 1169 (555-3413) pg/ml; p = 0.676). In contrast NT-proBNP values remained unchanged in UAP (182 (74-410) pg/ml) vs 171 (53-474) pg/ml).
  
  
  CONCLUSIONS
  The time interval from onset of symptoms to first blood collection is an important determinant for NT-proBNP values on admission in patients with an ACS and needs to be considered in clinical practice.
authors.affiliation: Kerckhoff Heart Center, Department of Cardiology, Bad Nauheim, Germany. M.Weber@kerckhoff-klinik.de
authors.forename: M
authors.initials: M
authors.lastname: Weber
authors.forename: C
authors.initials: C
authors.lastname: Kleine
authors.forename: E
authors.initials: E
authors.lastname: Keil
authors.forename: M
authors.initials: M
authors.lastname: Rau
authors.forename: A
authors.initials: A
authors.lastname: Berkowitsch
authors.forename: A
authors.initials: A
authors.lastname: Elsaesser
authors.forename: V
authors.initials: V
authors.lastname: Mitrovic
authors.forename: C
authors.initials: C
authors.lastname: Hamm
mesh_terms: D000789:Angina, Unstable / Q000097:blood* / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013577:Syndrome
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain