N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with non-ST-elevation myocardial infarction (NSTEMI) compared to patients with unstable angina (UA) in a lot of patients admitted for non-ST-elevation acute coronary syndrome (NSTE-ACS)
A. Pascu1, M. Radoi1, A. Bisoc1, D. Barbu1, I. Barbu1, C. Ciurea1, G. Totoianu2 & M. Stanciu2
Introduction: The study aimed to evaluate the differences in secretion of NT-proBNP and cardiac troponin T (cTnT), in patients with NSTE-ACS for the early detection of myocardial ischemia in NSTE-ACS.
Methods: Hundred and sixteen patients admitted for non-ST-elevation ACS (NSTE-ACS), 71(61.2%) men, mean age 68.7±10.2 were prospectively investigated. Plasma NT-proBNP and cTnT were measured by electrochemiluminescence (Elecsys/Cobas e, Roche Diagnostics) on admission. Study population was divided into two groups, based on clinical findings, 12-lead electrocardiography (ECG), 2D echocardiograpy (ECHO) and the plasma cut-off level of cTnT =0.1 ng/ml, as follows: group 1, consisiting of n=34 (29.3)% patients with NSTEMI (cTnT ≥ 0.1 ng/ml) and group 2, including n=82 (70.7)% patients with UA (cTnT <0.1 ng/ml). Study protocol was approved by the local Ethics Committee and each patient enrolled signed an informed consent. Statistics: SPSS 16.0.; MedCalc 11.4.4.
Results: Plasma levels of NT-proBNP were significantly higher in patients with NSTEMI (group 1) compared to patients with UA (group 2): 1115 (235.7; 2289.5) vs 155.6 (60.4; 313.6) pg/ml, P<0.0001 values expressed as median (25th; 75th percentile). NT-proBNP did not significantly correlate to cTnT (R=0.3, P=0.1). The area under the receiver operating characteristic curve (AUC) for NT-proBNP in discriminating patients with NSTEMI from those with UA was 0.68 (95% Confidence Interval C.I. 0.55 - 0.81), P < 0.001.
Conclusion: Plasma levels of NT-proBNP was significantly higher in patients with non-ST-elevation acute myocardial infarction compared to patients with unstable angina, but did not significantly correlate with plasma levels of cTnT in our study group of patients with non-ST-elevation acute coronary syndrome.
This work is part of the Scientific Research Project No. 17678/2010-2011, supported by Roche Diagnostics.
Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.
Funding: This work was supported, however funding details unavailable.