Fig. 8. Six-month mortality according to NT-proBNP levels: (A) TIMI risk categories (0-2, low risk; 3-4, intermediate risk; 5-7, high risk) and (B) ACC/AHA classification (non-high risk and high risk). (Adapted from ref. 60.)

regarding their ability to predict nonfatal recurrent ischemic events. Thus, BNP and NT-proBNP should be considered as markers predominantly of death and heart failure rather than nonfatal recurrent ischemic events. Several additional areas need to be addressed regarding the future role of BNPs in clinical practice. Although some data support routine early invasive management for patients with elevated levels of BNP/NT-proBNP, the optimal therapeutic responses to abnormal BNP results are not yet defined. Other treatment options may be explored, optimally in randomized clinical trials, to identify therapies that may be effective in decreasing the high mortality and morbidity in patients with high plasma levels of these natriuretic peptides.

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