title: [Prognostic value of levels of brain natriuretic peptide and genetic factors in patients after acute coronary syndrome].
abstract: Prognostication of the course of disease in patients with high risk of unfavorable outcome of ischemic heart disease (IHD) is of great importance for creation of individualized strategy of treatment. We have investigated contribution of levels of brain natriuretic peptide (BNP) and genetic factors in the risk of development of complications of atherosclerosis in patients who have had acute coronary syndrome. We started to follow 324 patients on day 10 of stable state after acute coronary syndrome (55.1% with Q-wave myocardial infarction, 18.5% with non-Q myocardial infarction, 25.5% with unstable angina, men BNP level 624.5+/-32.13 mol/ml [70.3 - 4276.6]). Duration of followup was 2 years. Baseline BNP level in patients with unfavorable outcome during followup (fatal and nonfatal myocardial infarction and stroke) was 872.47+/-91.42 compared with 592.45+/-35.97 mol/ml in patients without unfavorable outcome (p=0,001). Multifactorial Cox analysis showed that carriage of T allele of polymorphic marker (--1654) of protein C gene, elevated BNP level, symptomatic atherosclerosis of peripheral arteries, history of MI, and use of thiazide diuretics were independently associated with unfavorable outcomes (p=0.026, &lt;0.0001, &lt;0.0001, =0.001, =0.024, respectively). Thus genetic factors and study of BNP allow to improve prediction of unfavorable outcome after exacerbation of IHD.
authors.forename: M A
authors.initials: MA
authors.lastname: Evdokimova
authors.forename: O Iu
authors.initials: OIu
authors.lastname: Aseĭcheva
authors.forename: T N
authors.initials: TN
authors.lastname: Baklanova
authors.forename: O S
authors.initials: OS
authors.lastname: Chumakova
authors.forename: E Iu
authors.initials: EIu
authors.lastname: Panfilova
authors.forename: N E
authors.initials: NE
authors.lastname: Reznichenko
authors.forename: A N
authors.initials: AN
authors.lastname: Brovkin
authors.forename: A G
authors.initials: AG
authors.lastname: Nikitin
authors.forename: Iu V
authors.initials: IuV
authors.lastname: Agapkina
authors.forename: V S
authors.initials: VS
authors.lastname: Osmolovskaia
authors.forename: M Iu
authors.initials: MIu
authors.lastname: Kockina
authors.forename: N D
authors.initials: ND
authors.lastname: Selezneva
authors.forename: A A
authors.initials: AA
authors.lastname: Zateĭshchikova
authors.forename: P A
authors.initials: PA
authors.lastname: Talyzin
authors.forename: B A
authors.initials: BA
authors.lastname: Sidorenko
authors.forename: V V
authors.initials: VV
authors.lastname: Nosikov
authors.forename: D A
authors.initials: DA
authors.lastname: Zateĭshchikov
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis / Q000235:genetics; D000483:Alleles; D017023:Coronary Angiography; D004247:DNA / Q000235:genetics*; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016133:Polymerase Chain Reaction; D011110:Polymorphism, Genetic; D011379:Prognosis; D011486:Protein C / Q000235:genetics* / Q000378:metabolism; D013997:Time Factors
chemical_list: D011486:Protein C; D020097:Natriuretic Peptide, Brain; D004247:DNA