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Natriuretic peptides for risk stratification of patients with acute coronary syndromes
Author(s) -
Galvani Marcello,
Ferrini Donatella,
Ottani Filippo
Publication year - 2004
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2004.01.006
Subject(s) - medicine , risk stratification , cardiology , stratification (seeds) , heart failure , acute coronary syndrome , natriuretic peptide , intensive care medicine , myocardial infarction , biology , seed dormancy , botany , germination , dormancy
Natriuretic peptides (BNP and NT‐proBNP) have been shown to be useful tools for risk stratification of patients with acute myocardial ischemia encompassing the whole spectrum of acute coronary syndromes (ACS), particularly for prediction of mortality. Both BNP and NT‐proBNP possess several characteristics of the ideal biomarker, showing independent and incremental prognostic value above traditional clinical, electrocardiographic, and biochemical (particularly troponin) risk indicators. Specifically, in ACS patients, BNP and NT‐proBNP have powerful prognostic value both in patients without a history of previous heart failure or without clinical or instrumental signs of left ventricular dysfunction on admission or during hospital stay. They can also be easily and rapidly measured in an emergency context. We have performed a meta‐analysis of available studies concerning the prognostic value of natriuretic peptides. Our results show that the prognostic value of natriuretic peptides is similar: (1) both at short‐ and long‐term; (2) when natriuretic peptides are measured at first patient contact or during hospital stay; (3) for BNP or NT‐proBNP; and (4) in patients with ST elevation myocardial infarction or no ST elevation ACS. These data suggest that natriuretic peptide measurement should be integrated into routine evaluation of patients with an ACS.