Role of early assessment of NT-proBNP in patients with acute coronary syndrome

Aim of present study was to evaluate the short-term prognostic value of the early measurement of NT-proBNP in a wide cohort of patients encompassing the whole spectrum of ACS -especially patients with STEMI and NSTEMI.Methods: We enrolled n=50 patients admitted to our coronary care units with the diagnose ofacute coronary syndrome-ACS.We used diagnostic methods, such as: Resting ECG, determination of cardiacTroponin I level (cTnI), measurements of NT-proBNP, we also measured CK-MB and performed echocardiography, NT-proBNP measurement, echocardiography we performed also during follow up: 1-3 months later after the hospital discharge.Results: According our results totally NT-proBNP was elevated in 36% (n=18) of hispitalized patients who had not symptoms of heart failure and were hospitalized because of ACS (STEMI and NSTEMI).All these patients were investigated after 1-3 months from hospital discharge.In our study group we had not no one case of patient death.seven patients (38,8%) had recurrent ischemic events (2 subsequent MI, 5 recurrent angina), and 11 (61%) had ymptoms of heart failure (NYHA II-III).We found correlation between NT-proBNP elevated level and decreased EF (ejection fraction) p<0.005 in STEMI group.Such kind of correlation wasn't found in NSTEMI group p<0.007, but during follow up we revealed direct correlation between recurrent episode of ischemia, heart failure symptoms, elevetated NT-Pro BNP level and decreased EF.Conclusions: Our data suggest that NT-proBNP levels, measured at admission can have predictive value for complications and short-term mortality in patients with ACS in both subgroups-STEMI and NSTEMI.Our results have practical implications, because the laboratory measurement of NT-proBNP we used has become commercially available and cost-effective it gives us ability to predict future complications and avoid them.