B-type natriuretic peptide: a novel early blood marker of acute myocardial infarction in patients with chest pain and no ST segment elevation

被引:102
作者
Bassan, R
Potsch, A
Maisel, A
Tura, B
Villacorta, H
Nogueira, MV
Campos, A
Gamarski, R
Masetto, AC
Moutinho, MA
机构
[1] Clin Sao Vicente, BR-22451100 Rio De Janeiro, Brazil
[2] Pro Cardiaco Hosp, Rio De Janeiro, Brazil
[3] VA San Diego Hlth Care Syst, Coronary Care Unit, San Diego, CA USA
关键词
acute coronary syndrome; acute myocardial infarction; natriuretic peptide;
D O I
10.1093/eurheartj/ehi033
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Aims This study was undertaken to determine the diagnostic value of admission B-type natriuretic peptide (BNP) for acute myocardial infarction (AMI) in patients with acute chest pain and no ST-segment elevation. Methods and results A prospective study with 631 consecutive patients was conducted in the emergency department. Non-ST elevation AMI was present in 72 patients and their median admission BNP level was significantly higher than in unstable angina and non-acute coronary syndrome patients. Sensitivity of admission BNP for AMI (cutoff value of 100 pg/mL) was significantly higher than creatine kinase-MB (CKMB) and troponin-I on admission (70.8 vs. 45.8 vs. 50.7%, respectively, P < 0.0001) and specificity was 68.9%. Simultaneous use of these markers significantly improved sensitivity to 87.3% and the negative predictive value to 97.3%. In multiple logistic regression analysis, admission BNP was a significant independent predictor of AMI, even when CKMB and troponin-I were present in the model. Conclusion BNP is a useful adjunct to standard cardiac markers in patients presenting to the emergency department with chest pain and no ST-segment elevation, particularly if initial CKMB and/or troponin-I are non-diagnostic.
引用
收藏
页码:234 / 240
页数:7
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