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Changes in NT-proBNP tied to higher cardiovascular risk in NSTEACS

25 Jul 2017

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.

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Most Read Articles
02 Dec 2017
The risk of congenital heart disease (CHD) Is significantly higher in foetuses conceived through in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI), according to a recent study.
Pearl Toh, 5 days ago
A higher dose of pitavastatin can benefit Japanese patients with stable coronary artery disease (CAD) compared with a low-dose pitavastatin, even though cardiovascular (CV) event incidence is known to be lower in Asian than Western patients, according to the REAL-CAD study presented at the AHA Scientific Sessions 2017.
01 Apr 2014
The basic life support (BLS) termination of resuscitation (TOR) rule recommends transport and continued resuscitation when cardiac arrest is witnessed by EMT-Ds, or there is a return of spontaneous circulation, or a shock is given.
03 Dec 2017
Treatment with the triple combination of amlodipine, losartan and rosuvastatin appears to be an effective therapeutic strategy for lowering blood pressure and low-density lipoprotein (LDL)-C levels in patients with comorbid hypertension and dyslipidaemia, according to a study.