title: B-type natriuretic peptide not TIMI risk score predicts death after acute coronary syndrome.
abstract: BACKGROUND
  The TIMI risk score is a clinical scoring system used to predict mortality in patients following an acute coronary syndrome (ACS). B-type natriuretic peptide (BNP) has also been found to be useful in this setting.
  
  
  METHODS
  80 patients (35 men, 45 women) mean (SD) age 70.68 (9.90) years with ACS were studied. Blood was drawn within 12 hours after the onset of ACS and the blood level of BNP was measured using Biosite Triage Cardioprofiler Panel (Biosite Inc., San Diego, CA, USA). Patient's TIMI risk score was recorded and patients were stratified into low (0 - 2), intermediate (3 - 4), and high-risk (5 - 7) groups.
  
  
  RESULTS
  Overall mortality at 18 months was 20% and was related to BNP levels but not the higher TIMI risk scores. Higher BNP levels were related to decreased survival (median (range) ng/mL, survivors: 166 (5 - 4,710) vs. deceased: 1,093.5 (71.3 - 4,840), p < 0.001). The optimal cutoff for the prediction of survival was 250 ng/mL. ACS patients with BNP over this cutoff have demonstrated the lower survival (log rank p < 0.001).
  
  
  CONCLUSIONS
  BNP measurement within the first 12 hours following an ACS is more easily performed and is more accurate than a clinical risk score at predicting long term mortality.
authors.affiliation: Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. sikre@mahidol.ac.th
authors.forename: Kanit
authors.initials: K
authors.lastname: Reesukumal
authors.forename: Busadee
authors.initials: B
authors.lastname: Pratumvinit
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000401:mortality* / Q000503:physiopathology; D000368:Aged; D015415:Biomarkers / Q000097:blood; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D015996:Survival Rate; D013785:Thailand / Q000453:epidemiology; D013927:Thrombosis / Q000209:etiology / Q000401:mortality*; D013997:Time Factors
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain