Changes in NT-proBNP tied to higher cardiovascular risk in NSTEACS
Changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) are associated with cardiovascular risks in non-ST-segment elevation acute coronary syndrome (NSTEACS), a new study has shown.
In 1,665 NSTEACS patients (median age 65.0 years; 38.3 percent female), the change in NT-proBNP levels from baseline to six months was significantly associated with higher risks of CV death (hazard ratio [HR], 1.14; 95 percent CI, 1.03 to 1.27; p=0.01) and all-cause death (HR, 1.14; 1.04 to 1.26; p<0.01).
In comparison, only the risk of all-cause death was significantly associated with the change in NT-proBNP from baseline to 30 days (HR, 1.15; 1.03 to 1.28; p=0.01).
NT-proBNP levels at baseline and at 30 days were associated significantly with cardiovascular (CV) death (HR, 1.17; 1.07 to 1.28; p<0.01 and HR, 1.24; 1.09 to 1.41; p<0.01, respectively), all-cause death (HR, 1.15; 1.06 to 1.25; p<0.01 and HR, 1.23; 1.09 to 1.38; p<0.01, respectively) and CV events (HR, 1.07; 1.01 to 1.14; p=0.02 and HR, 1.11; 1.02 to 1.22; p=0.02, respectively).
Additionally, NT-proBNP levels at 6 months were also significantly associated with CV events (HR, 1.13; 1.04 to 1.24; p<0.01), CV death (HR, 1.20; 1.08 to 1.33; p<0.01), myocardial infarction (MI; HR, 1.15; 1.02 to 1.30; p=0.02) and all-cause death (HR, 1.18; 1.07 to 1.29; p<0.01).
On the other hand, only the change in hs-CRP from baseline to 6 months was associated with higher risks of CV events (HR, 1.09; 1.02 to 1.17; p=0.02) and myocardial infarction (HR, 1.10; 1.00 to 1.20; p=0.04).
NT-proBNP and hs-CRP levels were measured at three timepoints: at baseline, at 30 days and at 6 months. The primary endpoint was the composite outcome of CV death, nonfatal stroke and nonfatal MI. Cox proportional hazards was used to determine the correlation of biomarker levels with cardiovascular outcomes.