B-TYPE NATRIURETIC PEPTIDE(BNP) LEVELS AND ITS PROGNOSTIC VALUE IN ACUTE CORONARY SYNDROMES(ACS)

Abstract

Objectives: This study was designed to evaluate the prognostic value of B-type natriuretic peptide (BNP) in patients across the entire spectrum of acute coronary syndromes (ACS). Method: We measured BNP levels at baseline in 100 consecutive patients between 24-96 hours after the onset of ischemic symptoms in patients of acute coronary syndromes. We did comparison between BNP levels and established prognostic markers Trop-T to determine short term morbidity and mortality. Results: Patients with baseline BNP levels (> 80pg/ml, n=28) were at higher risk of new or progressive congestive heart failure (CHF) [17.8% vs. 1.39%, P = 0.002), new or recurrent myocardial infarction [17.8% vs. 2.8, P = 0.008) and death [17.8% vs. 1.39%, P= 0.002) within a period of 30 days. The mortality within 30 days in patients with BNP > 80pg/ml was 17.9% (P=0.002)compared to 5.7%(P=0.718) in patients with positive Trop-T (> 0.1ng/ml). Conclusion: A single measurement of BNP obtained between 24-96 hours after the onset of ischemic symptoms provides predictive information for use in risk stratifications across the spectrum of acute coronary syndromes. Cardiac neurohormonal activation may be a unifying feature among patients at high risk for death after acute coronary syndromes. BNP levels should be measured in all patients of Acute coronary syndromes.