title: NT-proBNP for prognostic and diagnostic evaluation in patients with acute coronary syndromes.
abstract: OBJECTIVE
  N terminal-proB-type natriuretic peptide (NT-proBNP) is synthesised and secreted from the ventricular myocardium. This marker is known to be elevated in patients with acute coronary syndromes (ACS). We evaluated NT-proBNP asa significant diagnostic marker and an important independent predictor of short-term mortality (one month) in patients with ACS.
  
  
  METHODS
  NT-proBNP and cardiac troponin I (cTI) were assessed in 134 consecutive patients (median age 66 years, 73% male)hospitalised for ACS in a cardiological university department. The patients were classified into ST-elevation ACS (STE-ACS, n = 74) and non-ST-elevation ACS (NSTE-ACS, n = 60) groups based on the ECG findings on admission. Patients with Killip class ≥ II were excluded.
  
  
  RESULTS
  The serum level of NT-proBNP on admission was significantly higher (p < 0.0005), while there was no difference in cTI serum level in the NSTE-ACS patients compared to STE-ACS patients. There was a significant positive correlation between NT-proBNP and cTI in the NSTE-ACS (r = 0.338, p = 0.008) and STE-ACS (r = 0.441, p < 0.0005) patients. There was a significant difference in NT-proBNP (p < 0.0005) and cTI (p < 0.0005) serum level between ACS patients who died within 30 days or who survived after one month. The increased NT-proBNP level is the strongest predictor of mortality in ACS patients, also NT-proBNP cut-point level of 1,490 pg/mL is a significant independent predictor of mortality.
  
  
  CONCLUSIONS
  We demonstrated the differences and the correlation in the secretion of NT-proBNP and cTI in patients with STE-ACS vs. NSTE-ACS. Our results provide evidence that NT-proBNP is a significant diagnostic marker and an important independent predictor of short-term mortality in patients with ACS.
authors.affiliation: Department of Cardiology, Clinical Centre Kragujevac, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia. zdravkovic_nemanja@yahoo.com
authors.forename: Vladimir
authors.initials: V
authors.lastname: Zdravkovic
authors.forename: Violeta
authors.initials: V
authors.lastname: Mladenovic
authors.forename: Maja
authors.initials: M
authors.lastname: Colic
authors.forename: Dragic
authors.initials: D
authors.lastname: Bankovic
authors.forename: Zorica
authors.initials: Z
authors.lastname: Lazic
authors.forename: Marina
authors.initials: M
authors.lastname: Petrovic
authors.forename: Ivan
authors.initials: I
authors.lastname: Simic
authors.forename: Slavko
authors.initials: S
authors.lastname: Knezevic
authors.forename: Sveto
authors.initials: S
authors.lastname: Pantovic
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Djukic
authors.forename: Nemanja
authors.initials: N
authors.lastname: Zdravkovic
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D017202:Myocardial Ischemia / Q000097:blood* / Q000175:diagnosis*; D009206:Myocardium / Q000473:pathology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009336:Necrosis / Q000097:blood; D010446:Peptide Fragments / Q000097:blood*; D062645:Percutaneous Coronary Intervention; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D015607:Stents; D015996:Survival Rate; D019210:Troponin I / Q000097:blood*
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D019210:Troponin I; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain