Prognostic value of plasma brain natriuretic peptide and C-reactive protein in patients with acute coronary syndromes underwent percutaneous coronary intervention.

Ben HE; Song Ding; Jun PU; Jian-ping Liu; Wei Song; Yong-ping DU; Jie-yan Shen; Shu-xuan Jin; Yu Sun; Long Shen

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Prognostic value of plasma brain natriuretic peptide and C-reactive protein in patients with acute coronary syndromes underwent percutaneous coronary intervention.

Author: Ben HE ¹ ; Song DING ; Jun PU ; Jian-ping LIU ; Wei SONG ; Yong-ping DU ; Jie-yan SHEN ; Shu-xuan JIN ; Yu SUN ; Long SHEN
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1. Department of Cardiology, Renji Hospital, Shanghai Jiaotong University, Shanghai 200127, China. heben@medmail.com.cn
Publication Type:Journal Article
MeSH: Acute Coronary Syndrome; blood; diagnosis; therapy; Adult; Aged; Aged, 80 and over; Angioplasty, Balloon, Coronary; C-Reactive Protein; metabolism; Female; Follow-Up Studies; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; blood; Predictive Value of Tests; Prognosis
From: Chinese Journal of Cardiology 2006;34(4):349-352
CountryChina
Language:Chinese
Abstract:
OBJECTIVETo evaluate the prognostic value of plasma brain natriuretic peptide (BNP) and C-reactive protein (CRP) in patients with acute coronary syndromes (ACS) underwent percutaneous coronary intervention (PCI).
METHODSPatients with ACS underwent PCI in our hospital from December 2004 to September 2005 were included in this study. Plasma BNP (n = 189) and CRP (n = 141) were measured at a median of (34.2 +/- 16.3) hours from symptom onset, total mortality and the risk for major adverse cardiac events (MACE, including death, recurrent MI, recurrent angina, heart failure, readmission for any reason) at 30 days and at 3 months was analyzed.
RESULTSPatients were divided into 4 groups according to their BNP levels (BNP 100 ng/L to 300 ng/L to 600 ng/L) and the 3-month mortality was 0%, 1.4%, 7.7%, 48.3% and 3-month incidence of MACE was 7.9%, 17.1%, 57.7%, 79.3% respectively. Multivariate logistic regression analyses showed that the plasma BNP level predicted 30-day (r = 0.8515, P < 0.01) and 3-month (r = 0.9201, P < 0.01) mortality and 30-day (r = 0.7066, P < 0.01) and 3-month (r = 0.7090, P < 0.01) incidence of MACE independent of other known prognostic factors such as age, gender, family heredity, hypercholesterolemia diabetes, hypertension, smoking and LVEF. Patients were divided into 3 groups according to their CRP levels (CRP 8.0 mg/L to 32.0 mg/L) and 3-month mortality was 2.7%, 7.7% and 28.6% and 3-month incidence of MACE was 28.4%, 41.0% and 60.7% respectively. CRP predicted 30-day (r = 0.5882, P = 0.0044) and 3-month (r = 0.5235, P = 0.0038) mortality independent of traditional risk factors, and predicted 30-day (r = 0.2705, P = 0.0380) and 3-month (r = 0.2290, P = 0.0429) incidence of MACE after adjustment for patient age. CRP lost its predictive value after BNP was introduced into the model, while BNP was still an independent predictor for mortality and incidence of MACE at 30 days and 3 months in ACS patients underwent PCI.
CONCLUSIONBoth plasma BNP and CRP are good predictors for early mortality and MACE incidence in ACS patients underwent PCI.