B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina

BMC Cardiovascular Disorders

Research Article

Patricio Gallo¹  Ricardo León de la Fuente²  Patrycja A Naesgaard³  Leik Woie³  Dennis WT Nilsen⁴  Heidi Grundt⁵  Torbjoern Aarsland⁶  Stein Tore Nilsen⁷  Harry Staines⁸ 

[1] Cardiology Research Institute, Catholic University of Salta, Salta, Argentina;Cardiology Research Institute, Catholic University of Salta, Salta, Argentina;Department of Cardiology, Stavanger University Hospital, Stavanger, Norway;Department of Cardiology, Stavanger University Hospital, Stavanger, Norway;Department of Cardiology, Stavanger University Hospital, Stavanger, Norway;Institute of Medicine, University of Bergen, Bergen, Norway;Department of Medicine, Stavanger University Hospital, Stavanger, Norway;Institute of Medicine, University of Bergen, Bergen, Norway;Department of Research, Stavanger University Hospital, Stavanger, Norway;Department of Research, Stavanger University Hospital, Stavanger, Norway;Institute of Clinical Medicine, University of Bergen, Bergen, Norway;Sigma Statistical Services, Balmullo, UK;

关键词: Percutaneous Coronary Intervention;    Acute Coronary Syndrome;    Cardiac Death;    Acute Coronary Syndrome Patient;    hsCRP Level;   

DOI  :  10.1186/1471-2261-11-57

 received in 2011-07-07, accepted in 2011-09-29,  发布年份 2011

来源: Springer

【 摘 要 】

BackgroundSeveral mechanisms are involved in the pathophysiology of the Acute Coronary Syndrome (ACS). We have addressed whether B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hsCRP) in admission samples may improve risk stratification in chest pain patients with suspected ACS.MethodsWe included 982 patients consecutively admitted with chest pain and suspected ACS at nine hospitals in Salta, Northern Argentina. Total and cardiac mortality were recorded during a 2-year follow up period. Patients were divided into quartiles according to BNP and hsCRP levels, respectively, and inter quartile differences in mortality were statistically evaluated applying univariate and multivariate analyses.Results119 patients died, and the BNP and hsCRP levels were significantly higher among these patients than in survivors. In a multivariable Cox regression model for total death and cardiac death in all patients, the hazard ratio (HR) in the highest quartile (Q4) as compared to the lowest quartile (Q1) of BNP was 2.32 (95% confidence interval (CI), 1.24-4.35), p = 0.009 and 3.34 (95% CI, 1.26-8.85), p = 0.015, respectively. In the TnT positive patients (TnT > 0.01 ng/mL), the HR for total death and cardiac death in Q4 as compared to Q1 was 2.12 (95% CI, 1.07-4.18), p = 0.031 and 3.42 (95% CI, 1.13-10.32), p = 0.029, respectively.The HR for total death for hsCRP in Q4 as compared to Q1 was 1.97 (95% CI, 1.17-3.32), p = 0.011, but this biomarker did not predict cardiac death (p = 0.21). No prognostic impact of these two biomarkers was found in the TnT negative patients.ConclusionBNP and hsCRP may act as clinically useful biomarkers when obtained at admission in a population with suspected ACS.Trial RegistrationClinicalTrials.gov Identifier: NCT01377402.

【 授权许可】

Unknown   
© de la Fuente et al; licensee BioMed Central Ltd. 2011. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.