title: The prognostic value of N-terminal pro-brain natriuretic peptide in non-ST elevation acute coronary syndromes: a meta-analysis.
abstract: BACKGROUND
  Precise risk stratification is important in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) on determination for hospitalization and intensity of treatment. A meta-analysis was performed in studies of patients with NSTE-ACS to evaluate the predictive nature of elevated N-terminal pro-brain natriuretic peptide (NT-proBNP).
  
  
  METHODS
  Online searches were conducted using database to identify suitable studies. A summary of relative risks (RRs) for death and myocardial infarction (MI) was calculated using random-effects modeling. We also calculated the pooled sensitivity, specificity, positive predictive value, and negative predictive value.
  
  
  RESULTS
  Thirteen studies were included. Elevated NT-proBNP levels were significantly associated with mortality [RR 4.89; 95% confidence interval (CI) 3.85–6.22] and incidence of MI (RR 1.66; 95% CI 1.24–2.22). The sensitivity and specificity for MI was 69.1% (95% CI 66.6%–71.6%) and 43.6% (95% CI 42.9%–44.3%), respectively, along with the positive and negative predictive values for MI of 8.2% (95% CI 7.7%–8.7%) and 95.1% (95% CI 94.6%–95.5%), respectively.
  
  
  CONCLUSIONS
  Meta-analysis suggests that elevated NT-proBNP levels were associated with an increased risk for MI or death in patients with NSTE-ACS. Normal levels of NT-proBNP are certainly more helpful when selecting NSTE-ACS patients with likelihood for favorable outcomes.
authors.affiliation: Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, PR China.
authors.forename: Xiaocong
authors.initials: X
authors.lastname: Zeng
authors.forename: Lang
authors.initials: L
authors.lastname: Li
authors.forename: Qiang
authors.initials: Q
authors.lastname: Su
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000503:physiopathology*; D000368:Aged; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000032:analysis*; D010446:Peptide Fragments / Q000032:analysis*; D011237:Predictive Value of Tests; D011379:Prognosis
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain