Document Detail

Predicting outcome in patients with acute coronary syndrome: evaluation of B-type natriuretic peptide and the global registry of acute coronary events (GRACE) risk score.
MedLine Citation:
PMID:  17874709     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Accurate risk stratification soon after admission for patients with acute coronary syndromes (ACS) is vital in guiding management. Clinical risk scores and B-type natriuretic peptide (BNP) can predict mortality and re-infarction in ACS, but it is unknown whether BNP provides prognostic information over and above that of the clinical risk scores. METHODS: 142 unselected patients with ACS were prospectively studied. BNP was measured and patients were stratified according to BNP and Global Registry of Acute Coronary Events (GRACE) score. In-hospital and 30-day events were characterised. RESULTS: 20.4% of ACS subjects had ST-elevation myocardial infarction (MI), 14.1%, non-ST elevation MI and 65.5% unstable angina. Elevated BNP predicted in-hospital and 30-day heart failure (p<0.01), and the risk of in-hospital recurrent ACS (p<0.05). Increasing GRACE score predicted in-hospital recurrent ACS (p<0.05), heart failure (p<0.001), arrhythmias (p<0.05) and angioplasty (p<0.05). GRACE score also predicted 30-day heart failure (p<0.05). In contrast, the predictive accuracy of troponin elevation was less robust. CONCLUSION: BNP and the GRACE score predict complementary outcomes from ACS, but both predicted heart failure. BNP is a powerful indicator of heart failure in patients with ACS and provides prognostic information above and beyond conventional biomarkers and risk scores.
H Sinclair; M Paterson; S Walker; G Beckett; K A A Fox
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Scottish medical journal     Volume:  52     ISSN:  0036-9330     ISO Abbreviation:  Scott Med J     Publication Date:  2007 Aug 
Date Detail:
Created Date:  2007-09-18     Completed Date:  2007-11-05     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983335R     Medline TA:  Scott Med J     Country:  Scotland    
Other Details:
Languages:  eng     Pagination:  8-13     Citation Subset:  IM    
Cardiovascular Research, The University of Edinburgh, Chancellor's Building, Little France Crescent, Edinburgh.
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MeSH Terms
Angina, Unstable / diagnosis
Coronary Disease / blood,  diagnosis*,  mortality
Myocardial Infarction / diagnosis
Natriuretic Peptide, Brain / blood*
Prospective Studies
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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