Different patterns of NT-proBNP secretion in acute coronary syndromes.
BACKGROUND; The wide variability of NT-proBNP levels in acute coronary syndromes could arise from sympathetic activation and glomerular impairment. The aim of the study was to investigate, in this setting, the dependence of NT-proBNP from Chromogranin A (CgA) and Cystatin C (CC) levels, respectively assessing sympathetic activation and glomerular impairment.


METHODS
In 132 patients, 90 ST elevation acute coronary syndrome (STE-ACS) and 42 non ST elevation acute coronary syndrome (NSTE-ACS), within 24 h from symptoms and with creatinine levels lower than 141.4 micromol/L, we measured NT-proBNP, CgA and CC levels. In 41 STE-ACS patients we evaluated the kinetic profiles of the markers.


RESULTS
From the multiple regression model, to investigate the dependence of NT-proBNP from CgA, CC levels, time from symptoms, STE-ACS/NSTE-ACS subsets, gender, adjusting for the effect of left ventricular ejection fraction and age we had evidence of: 1) interactions involving the subsets, the first with CgA levels and the second with age; 2) non linear increasing effect of the delay on NT-proBNP secretion.


CONCLUSIONS
Our data showed that, in the population studied, sympathetic activation and age could affect NT-proBNP secretion yielding different secretory patterns in STE- or NSTE-ACS. Only for STE-ACS we observed higher marker secretion in older patients.
Ferraro
Simona
S
SCDO Cardiologia, Ospedale Maggiore, Novara, Italy. simona.ferraro@maggioreosp.novara.it
Lupi
Alessandro
A
Marano
Giuseppe
G
Rossi
Lidia
L
Ciardi
Laura
L
Vendramin
Chiara
C
Bellomo
Giorgio
G
Boracchi
Patrizia
P
Bongo
Angelo Sante
AS
Biganzoli
Elia
E
D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis*; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D053379:Chromogranin A / Q000097:blood*; D055316:Cystatin C / Q000097:blood*; D005260:Female; D006801:Humans; D007700:Kinetics; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood* / Q000378:metabolism; D010446:Peptide Fragments / Q000097:blood* / Q000378:metabolism
D053379:Chromogranin A; D055316:Cystatin C; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain