title: BNP and admission glucose as in-hospital mortality predictors in non-ST elevation myocardial infarction.
abstract: OBJECTIVE
  Admission hyperglycemia and B-type natriuretic peptide (BNP) are associated with mortality in acute coronary syndromes, but no study compares their prediction in-hospital death.
  
  
  METHODS
  Patients with non-ST-elevation myocardial infarction (NSTEMI), in-hospital mortality and two-year mortality or readmission were compared for area under the curve (AUC), sensitivity (SEN), specificity (SPE), positive predictive value (PPV), negative predictive value (NPV), and accuracy (ACC) of glycemia and BNP.
  
  
  RESULTS
  Respectively, AUC, SEN, SPE, PPV, NPV, and ACC for prediction of in-hospital mortality were 0.815, 71.4%, 84.3%, 26.3%, 97.4%, and 83.3% for glycemia = 200 mg/dL and 0.748, 71.4%, 68.5%, 15.2%, 96.8% and 68.7% for BNP = 300 pg/mL. AUC of glycemia was similar to BNP (P = 0.411). In multivariate analysis we found glycemia ≥200mg/dL related to in-hospital death (P = 0.004). No difference was found in two-year mortality or readmission in BNP or hyperglycemic subgroups.
  
  
  CONCLUSIONS
  Hyperglycemia was an independent risk factor for in-hospital mortality in NSTEMI and had a good ROC curve level. Hyperglycemia and BNP, although poor in-hospital predictors of unfavorable events, were independent risk factors for death or length of stay >10 days. No relation was found between hyperglycemia or BNP and long-term events.
authors.affiliation: Heart Institute (InCor), University of São Paulo Medical School, Avenue Enéas de Carvalho de Aguiar 44, 05403-000 São Paulo, SP, Brazil. jyt@bol.com.br
authors.forename: Julio Yoshio
authors.initials: JY
authors.lastname: Takada
authors.forename: Rogério Bicudo
authors.initials: RB
authors.lastname: Ramos
authors.forename: Solange Desiree
authors.initials: SD
authors.lastname: Avakian
authors.forename: Soane Mota
authors.initials: SM
authors.lastname: dos Santos
authors.forename: José Antonio Franchini
authors.initials: JA
authors.lastname: Ramires
authors.forename: Antonio de Pádua
authors.initials: Ade P
authors.lastname: Mansur
mesh_terms: D000368:Aged; D001786:Blood Glucose / Q000032:analysis*; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010343:Patient Admission
chemical_list: D001786:Blood Glucose; D020097:Natriuretic Peptide, Brain