January 1, 2006Circulation JournalOpen Access

Difference in Elevation of N-Terminal Pro-BNP and Conventional Cardiac Markers Between Patients With ST Elevation vs Non-ST Elevation Acute Coronary Syndrome

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Acute Coronary Syndrome (n=90). Intervention: Non-ST elevation acute coronary syndrome (NSTE-ACS) vs. ST elevation acute coronary syndrome (STE-ACS). Primary outcome: NT-proBNP level on admission (pg/ml) (p=0.0031).

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Key result

NT-proBNP levels on admission were significantly higher in patients with non-ST elevation acute coronary syndrome compared to those with ST elevation acute coronary syndrome (median 758 vs 208 pg/ml).

Population

90 consecutive patients admitted with acute chest pain and a diagnosis of unstable angina or acute…

Design

Cohort

Authors

AOAkio OgawaNippon Medical School YSYoshihiko SeinoNippon Medical School TYTeruyo YamashitaNippon Medical School

Discussion

Member takes

Implication

May refine early ACS risk stratification when ECG findings are equivocal; leaves open incremental value over troponin in prospective cohorts.

Study Design

Type

Observational (n=90)

Multicenter

Structured PICO

Population

90 consecutive patients with acute coronary syndrome without overt pump failure, evaluated at admission to compare cardiac marker elevations.

Outcome

Differences in elevation of NT-proBNP and conventional cardiac markers (CK-MB, TnT) on admission and according to time from onsetsurrogate

Main Result

Absolute Event Rate: 758% vs 208%

p-value: p=0.0031

NT-proBNP is an early, sensitive marker of myocardial ischemia that rises significantly higher in the early phase of NSTE-ACS compared to STE-ACS, independent of myocardial necrosis or heart failure.

Limitations

Did not analyze sequential changes in the markers in each patient.
Excluded patients with pump failure (≥Killip class II), confining the analysis to uncomplicated ACS.
Did not assess the dynamic changes of NT-proBNP synthesis/secretion during the process from the onset of ischemia to the development of pump failure.
Lack of comparison by radioisotope or positron emission tomography assessment during the acute phase to elucidate differences in ischemic area.
Did not analyze sequential changes in the markers in each patient
Excluded patients with pump failure (≥Killip class II), so dynamic changes of NT-proBNP synthesis/secretion during the process from onset of ischemia to development of pump failure were not assessed

Cite This Study

Ogawa et al. (2006) conducted an observational in Acute Coronary Syndrome (n=90). Non-ST elevation acute coronary syndrome (NSTE-ACS) vs. ST elevation acute coronary syndrome (STE-ACS) was evaluated on NT-proBNP level on admission (pg/ml) (p=0.0031). NT-proBNP levels on admission were significantly higher in patients with non-ST elevation acute coronary syndrome compared to those with ST elevation acute coronary syndrome (median 758 vs 208 pg/ml).

synapsesocial.com/papers/6a85b6f877bf9b21082018fd https://doi.org/10.1253/circj.70.1372

Topics

Women and heart disease

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Implication

May refine early ACS risk stratification when ECG findings are equivocal; leaves open incremental value over troponin in prospective cohorts.

Difference in Elevation of N-Terminal Pro-BNP and Conventional Cardiac Markers Between Patients With ST Elevation vs Non-ST Elevation Acute Coronary Syndrome

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Difference in Elevation of N-Terminal Pro-BNP and Conventional Cardiac Markers Between Patients With ST Elevation vs Non-ST Elevation Acute Coronary Syndrome

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider