Artikel
Lizenziert
Nicht lizenziert
Erfordert eine Authentifizierung
The value of N-terminal proB-type natriuretic peptide for early identification of myocardial infarction in patients with high-risk non-ST-elevation acute coronary syndromes
-
Robert K. Riezebos
Veröffentlicht/Copyright:
22. Juni 2011
Abstract
Background: N-terminal proB-type natriuretic peptide (NT-proBNP) is a marker of biomechanical strain, secreted by cardiomyocytes in response to ischemia. As necrosis occurs after prolonged ischemia, a rise in NT-proBNP concentration could precede a rise in markers of necrosis.
Methods: The aim of the study was to evaluate whether NT-proBNP is able to identify those patients with an evolving myocardial infarction (MI) with high-risk non-ST-elevation acute coronary syndromes (NSTE-ACS). Data were analyzed from a prospective cohort of 103 high-risk NSTE-ACS patients admitted within 6 h after onset of pain and treated with an early invasive strategy. NT-proBNP samples, obtained immediately upon admission, were related to the presence of an in hospital MI. The optimal cut-off value for NT-proBNP was determined using receiver-operating characteristics (ROC) curve analysis.
Results: Analyses was performed separately for creatinine kinase MB-mass (CKMB) and troponin T (TnT) based MI definitions. In both cases, a NT-proBNP concentration above 40 pmol/L (339 ng/L) at admission proved to be independently associated with the presence of MI. The diagnostic odds ratio (OR) for CKMB-MI was 4.9 (confidence interval 2.0–11.9, p<0.001). The diagnostic OR for TnT-MI was 4.9 (1.8–14.4, p=0.003). Adjusting for differences in baseline variables did not weaken the diagnostic OR. In addition, elevated NT-proBNP concentrations were related to unfavour-able demographic, physical and biochemical parameters.
Conclusions: With a dichotomous cut-off value, a single elevated NT-proBNP (>40 pmol/L) at admission provides independent information about the presence of MI in high-risk NSTE-ACS patients.
Keywords: acute coronary syndrome; myocardial infarction; N-terminal proB-type natriuretic peptide (NT-proBNP); troponin
Received: 2010-11-08
Accepted: 2011-03-21
Published Online: 2011-06-22
Published in Print: 2011-08-01
©2011 by Walter de Gruyter Berlin Boston
Sie haben derzeit keinen Zugang zu diesem Inhalt.
Sie haben derzeit keinen Zugang zu diesem Inhalt.
Artikel in diesem Heft
- Editorial
- Pneumatic tube delivery systems for patient samples: evidence of quality and quality of evidence
- Reviews
- Translating pharmacogenetics into clinical practice: interleukin (IL)28B and inosine triphosphatase (ITPA) polymophisms in hepatitis C virus (HCV) infection
- New biomarkers for acute renal injury
- Minireview
- Post-mortem biochemistry of vitreous humor and glucose metabolism: an update
- Opinion Paper
- International Osteoporosis Foundation and International Federation of Clinical Chemistry and Laboratory Medicine Position on bone marker standards in osteoporosis
- Guidelines and Recommendations
- IFCC international conventional reference procedure for the measurement of free thyroxine in serum
- Genetics and Molecular Diagnostics
- Improving clinical laboratory efficiency: a time-motion evaluation of the Abbott m2000 RealTime and Roche COBAS AmpliPrep/COBAS TaqMan PCR systems for the simultaneous quantitation of HIV-1 RNA and HCV RNA
- Enhanced frequency of CFTR gene variants in couples who are candidates for assisted reproductive technology treatment
- Customer satisfaction survey to improve the European cystic fibrosis external quality assessment scheme
- General Clinical Chemistry and Laboratory Medicine
- Effect of sample collection, temperature and time of storage on β-galactosidase and total hexosaminidase activities in dried blood collected on filter paper
- Agreement between paired blood gas values in samples transported either by a pneumatic system or by human courier
- Golgi protein 73(GP73), a useful serum marker in liver diseases
- The utility of six over-the-counter (home) pregnancy tests
- N Latex FLC – new monoclonal high-performance assays for the determination of free light chain kappa and lambda
- Alterations of the preoperative coagulation profile in patients with acute appendicitis
- Cerebrospinal fluid findings in infants with pertussis or parapertussis1)
- Calcium pyrophosphate and monosodium urate crystals in synovial fluid as a cause of pseudoeosinophilia
- Cardiovascular Disease
- Dual activity of serum lipoprotein-associated phospholipase A2 yielding positive and inverse associations with cardiometabolic risk
- The value of N-terminal proB-type natriuretic peptide for early identification of myocardial infarction in patients with high-risk non-ST-elevation acute coronary syndromes
- Infectious Diseases
- Diagnosis and genotyping of Plasmodium falciparum by a DNA biosensor based on quartz crystal microbalance (QCM)
- Evaluation of two automated chemiluminescence immunoassays, the LIAISON Treponema Screen and the ARCHITECT Syphilis TP, and the Treponema pallidum particle agglutination test for laboratory diagnosis of syphilis
- Letters to the Editor
- The preanalytical influence of two different mechanical transport systems on laboratory analysis
- Commutability of the ERM-DA470k Reference Material for two assays measuring serum albumin using immunochemical principles
- Performance evaluation of the Vitros®3600 immunodiagnostic system for the determination of free thyroid hormones
- Towards laboratory knowledge, not data, in 70% of clinical decision-making. What “knowledge management” can add to clinical practice?
- How to obtain DNA from injection drug users?
Schlagwörter für diesen Artikel
acute coronary syndrome;
myocardial infarction;
N-terminal proB-type natriuretic peptide (NT-proBNP);
troponin
Artikel in diesem Heft
- Editorial
- Pneumatic tube delivery systems for patient samples: evidence of quality and quality of evidence
- Reviews
- Translating pharmacogenetics into clinical practice: interleukin (IL)28B and inosine triphosphatase (ITPA) polymophisms in hepatitis C virus (HCV) infection
- New biomarkers for acute renal injury
- Minireview
- Post-mortem biochemistry of vitreous humor and glucose metabolism: an update
- Opinion Paper
- International Osteoporosis Foundation and International Federation of Clinical Chemistry and Laboratory Medicine Position on bone marker standards in osteoporosis
- Guidelines and Recommendations
- IFCC international conventional reference procedure for the measurement of free thyroxine in serum
- Genetics and Molecular Diagnostics
- Improving clinical laboratory efficiency: a time-motion evaluation of the Abbott m2000 RealTime and Roche COBAS AmpliPrep/COBAS TaqMan PCR systems for the simultaneous quantitation of HIV-1 RNA and HCV RNA
- Enhanced frequency of CFTR gene variants in couples who are candidates for assisted reproductive technology treatment
- Customer satisfaction survey to improve the European cystic fibrosis external quality assessment scheme
- General Clinical Chemistry and Laboratory Medicine
- Effect of sample collection, temperature and time of storage on β-galactosidase and total hexosaminidase activities in dried blood collected on filter paper
- Agreement between paired blood gas values in samples transported either by a pneumatic system or by human courier
- Golgi protein 73(GP73), a useful serum marker in liver diseases
- The utility of six over-the-counter (home) pregnancy tests
- N Latex FLC – new monoclonal high-performance assays for the determination of free light chain kappa and lambda
- Alterations of the preoperative coagulation profile in patients with acute appendicitis
- Cerebrospinal fluid findings in infants with pertussis or parapertussis1)
- Calcium pyrophosphate and monosodium urate crystals in synovial fluid as a cause of pseudoeosinophilia
- Cardiovascular Disease
- Dual activity of serum lipoprotein-associated phospholipase A2 yielding positive and inverse associations with cardiometabolic risk
- The value of N-terminal proB-type natriuretic peptide for early identification of myocardial infarction in patients with high-risk non-ST-elevation acute coronary syndromes
- Infectious Diseases
- Diagnosis and genotyping of Plasmodium falciparum by a DNA biosensor based on quartz crystal microbalance (QCM)
- Evaluation of two automated chemiluminescence immunoassays, the LIAISON Treponema Screen and the ARCHITECT Syphilis TP, and the Treponema pallidum particle agglutination test for laboratory diagnosis of syphilis
- Letters to the Editor
- The preanalytical influence of two different mechanical transport systems on laboratory analysis
- Commutability of the ERM-DA470k Reference Material for two assays measuring serum albumin using immunochemical principles
- Performance evaluation of the Vitros®3600 immunodiagnostic system for the determination of free thyroid hormones
- Towards laboratory knowledge, not data, in 70% of clinical decision-making. What “knowledge management” can add to clinical practice?
- How to obtain DNA from injection drug users?
