Multiple Biomarker Use for Detection of Adverse Events in Patients Presenting with Symptoms Suggestive of Acute Coronary Syndrome
Key result
In patients with suspected acute coronary syndrome, decreased eGFR (RR 3.4, P=0.004) and increased NT-proBNP (RR 7.9, P=0.04) were independently predictive of 4-month all-cause mortality.
Why the study?
Does the measurement of multiple biomarkers on admission predict adverse events in patients presenting with symptoms suggestive of acute coronary syndrome?
Population
457 patients presenting with symptoms suggestive of acute coronary syndrome
Comparison
Measurement of 7 biomarkers and estimated… vs Patients with biomarker concentrations within…
Design
Cohort
Follow-up
4 months
Authors
Discussion
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Member takes
Implication
May support mortality risk stratification with eGFR and NT-proBNP in suspected ACS; hypothesis-generating and requires prospective validation.
Study Design
Type
Cohort (n=457)
Structured PICO
Does the measurement of multiple biomarkers on admission predict adverse events in patients presenting with symptoms suggestive of acute coronary syndrome?
P
Population
457 patients presenting with symptoms of acute coronary syndrome, followed for 4 months.
E
Exposure
Measurement of 7 biomarkers (myeloperoxidase [MPO], soluble CD40 ligand [CD40L], placental growth factor [PlGF], metalloproteinase-9 [MMP-9], high-sensitivity C-reactive protein [hsCRP], cardiac troponin I [cTnI], and N-terminal pro-B-type natriuretic peptide [NT-proBNP]) and estimated glomerular filtration rate (eGFR) on admission
C
Comparator
Patients with biomarker concentrations within reference intervals
O
Outcome
Cardiac events (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, cardiac death) and all-cause mortality over a 4-month periodhard clinical
Multiple biomarkers, particularly NT-proBNP and eGFR, independently predict an increased risk of adverse events and mortality in patients presenting with suspected acute coronary syndrome.
Cite This Study
Apple et al. (2007) conducted a cohort in acute coronary syndrome (n=457). Multiple biomarkers (including eGFR, NT-proBNP, PlGF, hsCRP, cTnI) vs. Concentrations within reference intervals was evaluated on All-cause mortality and cardiac events (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, cardiac death). In patients with suspected acute coronary syndrome, decreased eGFR (RR 3.4, P=0.004) and increased NT-proBNP (RR 7.9, P=0.04) were independently predictive of 4-month all-cause mortality.