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KMID : 0385920080190010065
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Journal of the Korean Society of Emergency Medicine
2008 Volume.19 No. 1 p.65 ~ p.73
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Availability of Bedside N-terminal Pro- Brain Natriuretic Peptide Measurement as Prognostic Marker About Development of Major Adverse Cardiovascular Events in Patients of Acute Coronary Syndromes
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Kim Hye-Jin
Park Jun-Seok
Kim Ah-Jin
Roh Jun-Young
Kim Kyung-Hwan
Shin Dong-Wun
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Abstract
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Purpose: Natriuretic peptide levels are known to be associated with cardiac output and ventricular function. Recently it has been suggested that N-terminal pro-brain natriuretic peptide (NT-pro-BNP) is available as a prognostic marker for acute coronary syndrome patients. We compared NTpro- BNP levels between patients with and without major
adverse cardiovascular events (MACEs) who visited the emergency room due to acute coronary syndrome.
Methods: We designed a case-only study with study subjects recruited retrospectively by medical chart review.
Patients who visited the emergency room from 1 May 2006 to 31 February 2007 and were diagnosed with acute coronary
syndrome were enrolled. Subjects who did not receive bedside measurement of NT-proBNP levels were excluded.
To analyze by subtype of acute coronary syndrome, we classified study subjects into the following group: ST elevation
myocardial infarction, non-ST elevation myocardial infarction, or unstable angina.
Results: The level of NT-proBNP was 2,592±917 pg/ml in MACEs patients, and 1,289±1,261 pg/ml in patients without MACEs, a statistically significant difference (p<0.0001). The MACEs patients showed higher level of NT-proBNP
than patients without MACEs in the ST elevation myocardial infarction group (p=0.439), the non-ST elevation myocardial infarction group (p=0.004), and the unstable angina group (p=0.009).
Conclusion: Initial bedside NT-pro-BNP levels are higher in MACEs patients. Although the study size was small and the result should be carefully interpreted, it supports the hypothesis that NT-pro-BNP can as a marker to evaluate
MACEs in acute coronary syndrome.
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KEYWORD
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Pro-brain natriuretic peptide, Complications, Biologic markers
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