Prognostic Role of BNP and NTproBNP Across Spectrum of ACS

Studies of BNP

A substudy ofthe Orbofiban in Patients with Unstable Coronary Syndromes-Thrombo-lysis in Myocardial Infarction 16 (OPUS-TIMI 16) trial was among the first to evaluate the prognostic capabilities of BNP in a large population of patients across the entire spectrum of ACS (45). In this study, BNP was measured in 2525 patients at a mean of 40 h after presenting with STEMI, NSTEMI, or unstable angina. BNP levels on admission correlated with age, male gender, white race, hypertension, CHF, peripheral vascular disease, hypercholesterolemia, and smoking status. In addition, elevated levels of BNP were associated with Killip class >1, electrocardiogram (ECG) changes, elevated creatine kinase-MB, and chronic kidney disease. A plasma concentration of BNP > 80 pg/mL was a powerful

Fig. 4. Incidence of death and new CHF at 30 d and 10 mo following ACS in patients with a BNP <80 pg/mL (white bars) and >80 pg/mL (slashed bars). (Adapted from ref. 45.)

Age > 75

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