title: The influence of age on the clinical implications of N-terminal pro-B-type natriuretic peptide in acute coronary syndrome.
abstract: Currently, there are no studies addressing the influence of age on the prognostic information of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in Asian population with acute coronary syndrome (ACS). The purpose of this study was to investigate the prognostic performance of NT-proBNP in Chinese patients with ACS across different age groups. A total of 1512 ACS patients with venous blood NT-proBNP measured were enrolled. Patients were divided into tertiles based on their ages (<61, 61-71, ≥72 years). The median NT-proBNP concentrations in the three groups (T1-T3) were 406, 573, and 1288 pg/ml (p < 0.001), respectively. During a median follow-up of 23 months, 150 all-cause deaths occurred, and 88 (58.7 %) were attributed to cardiovascular cause. NT-proBNP levels are independently associated with mortality in each age group [1st group: HR 2.19 95 % CI (1.17-4.10); 2nd group: HR 1.82 95 % CI (1.04-3.20); 3rd group: HR 1.48 95 % CI (1.09-2.01), P interaction = 0.062]. NT-proBNP improves discrimination and reclassification for mortality beyond thrombolysis in myocardial infarction score in patients of all ages. The optimal NT-proBNP cutoff points for predicting mortality in three age groups are 1511, 2340, and 2883 pg/ml, respectively. In conclusion, NT-proBNP is a valuable biomarker in predicting long-term mortality and provides an improvement in discrimination and reclassification for prognosis in ACS patients of all ages.
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Fang-Yang
authors.initials: FY
authors.lastname: Huang
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Bao-Tao
authors.initials: BT
authors.lastname: Huang
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Jia-Yu
authors.initials: JY
authors.lastname: Tsauo
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Peng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Tian-Li
authors.initials: TL
authors.lastname: Xia
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Chen
authors.initials: C
authors.lastname: Zhang
authors.affiliation: Department of Family Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Rui-Shuang
authors.initials: RS
authors.lastname: Liu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Zhi-Liang
authors.initials: ZL
authors.lastname: Zuo
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Peng-Ju
authors.initials: PJ
authors.lastname: Wang
authors.affiliation: Department of Family Medicine, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Heng
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Xiao-Bo
authors.initials: XB
authors.lastname: Pu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Yi-Yue
authors.initials: YY
authors.lastname: Gui
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Shi-Jian
authors.initials: SJ
authors.lastname: Chen
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
authors.forename: Yan-Biao
authors.initials: YB
authors.lastname: Liao
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China. zhuye1974@163.com.
authors.forename: Ye
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China. hmaochen@vip.sina.com.
authors.forename: Mao
authors.initials: M
authors.lastname: Chen
mesh_terms: D054058:Acute Coronary Syndrome / Q000401:mortality / Q000503:physiopathology*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D009320:Atrial Natriuretic Factor / Q000032:analysis* / Q000097:blood; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011237:Predictive Value of Tests; D011379:Prognosis; D011498:Protein Precursors / Q000032:analysis* / Q000097:blood; D012307:Risk Factors
chemical_list: D015415:Biomarkers; C099254:N-terminal proatrial natriuretic peptide; D011498:Protein Precursors; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor
keywords: Age; Angina; Mortality; Myocardial infarction; N-terminal pro B-type natriuretic peptides