December 22, 2010Open Access
View Full PaperAssessment of multiple cardiac biomarkers in non-ST-segment elevation acute coronary syndromes: observations from the MERLIN-TIMI 36 Trial
Structured PICO
Do multiple cardiac biomarkers (cTnI, NT-proBNP, myeloperoxidase, hs-CRP) provide incremental prognostic information beyond clinical risk variables for adverse cardiovascular outcomes in patients with NSTEACS?
P
Population
Over 4300 patients presenting with non-ST-segment elevation acute coronary syndromes (NSTEACS) from the MERLIN-TIMI 36 Trial
I
Intervention
Measurement of multiple cardiac biomarkers (cTnI, NT-proBNP, myeloperoxidase, and hs-C-reactive protein)
C
Comparator
Clinical risk variables alone
O
Outcome
Cardiovascular death, myocardial infarction (MI), and heart failure (HF)hard clinical
In patients with NSTEACS, cTnI and NT-proBNP provide incremental prognostic value over clinical risk variables, while myeloperoxidase and hs-CRP do not add substantial further information.
Abstract
In this study of over 4300 patients presenting with NSTEACS, we found that both cTnI and NT-proBNP offer prognostic information beyond that achieved with clinical risk variables for CV death, MI, and HF. Myeloperoxidase and hs-C-reactive protein, while independently associated with some adverse CV outcomes, did not provide substantial incremental prognostic information when evaluated together with cTnI and NT-proBNP.