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The prognostic value of N-terminal pro-brain natriuretic peptide in non-ST elevation acute coronary syndromes: a meta-analysis

  • Xiaocong Zeng , Lang Li EMAIL logo and Qiang Su
Published/Copyright: December 15, 2011
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Clinical Chemistry and Laboratory Medicine
From the journal Clinical Chemistry and Laboratory Medicine Volume 50 Issue 4

Abstract

Background: Precise risk stratification is important in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) on determination for hospitalization and intensity of treatment. A meta-analysis was performed in studies of patients with NSTE-ACS to evaluate the predictive nature of elevated N-terminal pro-brain natriuretic peptide (NT-proBNP).

Methods: Online searches were conducted using database to identify suitable studies. A summary of relative risks (RRs) for death and myocardial infarction (MI) was calculated using random-effects modeling. We also calculated the pooled sensitivity, specificity, positive predictive value, and negative predictive value.

Results: Thirteen studies were included. Elevated NT-proBNP levels were significantly associated with mortality [RR 4.89; 95% confidence interval (CI) 3.85–6.22] and incidence of MI (RR 1.66; 95% CI 1.24–2.22). The sensitivity and specificity for MI was 69.1% (95% CI 66.6%–71.6%) and 43.6% (95% CI 42.9%–44.3%), respectively, along with the positive and negative predictive values for MI of 8.2% (95% CI 7.7%–8.7%) and 95.1% (95% CI 94.6%–95.5%), respectively.

Conclusions: Meta-analysis suggests that elevated NT-proBNP levels were associated with an increased risk for MI or death in patients with NSTE-ACS. Normal levels of NT-proBNP are certainly more helpful when selecting NSTE-ACS patients with likelihood for favorable outcomes.

Keywords: meta-analysis; mortality; non-ST elevation acute coronary syndromes; N-terminal pro-brain natriuretic peptide
Corresponding author: Lang Li, Department of Cardiology, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi 530021, P.R. China Phone: +86 771 2061167, Fax: +86 771 5314736
Received: 2011-7-1
Accepted: 2011-11-11
Published Online: 2011-12-15
Published in Print: 2012-04-01

©2012 by Walter de Gruyter Berlin Boston

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https://doi.org/10.1515/cclm.2011.824
Keywords for this article
meta-analysis; mortality; non-ST elevation acute coronary syndromes; N-terminal pro-brain natriuretic peptide

Articles in the same Issue

  1. A sensitive quantitative test strip based point-of-care albuminuria screening assay
  2. Editorials
  3. Serum biomarkers for the non-invasive diagnosis of liver fibrosis: the importance of being validated
  4. Primary blood tubes mixing: time for updated recommendations
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