ACTA FAC. MED. NAISS. 2006; 23 (3): 115-127

   Original article

Michael Weber, Christian Kleine, Eva Keil, Matthias Rau, Alexander Berkowitsch, Albrecht Elsaesser, Veselin Mitrovic, Christian Hamm

Kerckhoff Heart Centre, Departement of Cardiology, Bad Nauheim, Germany

    SUMMARY

    It has been found recently that BNP and NT-proBNP provide independent prognostic information in patients with acute coronary syndromes (ACS). However, little data are available on the time course of NT-proBNP levels in relation to onset of symptoms.

We included 765 patients (236 females, aged 64±11 years) with an ACS (STEMI 42%, NSTEMI 41%, UAP 17%) who were referred for coronary angiography. NT-proBNP was assessed on admission and the next day. NT-proBNP values were related to the time duration from the onset of symptoms until blood drawing with lowest values within 3 hours and highest values 24-36 hours after the onset of symptoms (147 (64-436) pg/ml and 1099 (293-3795) pg/ml respectively, p<0.001). Highest values for NT-proBNP on admission were found in patients with NSTEMI compared to patients with STEMI and UAP (912 (310-2258) pg/ml) vs. 262 (85-1282) pg/ml) vs. 182 (74-410) pg/ml; p<0.001), but no difference was found between STEMI and NSTEMI the day after admission (1325 (532-2974) pg/ml vs. 1169 (555-3413) pg/ml; p=0.676). In contrast, NT-proBNP values remained unchanged in UAP (182 (74-410) pg/ml) vs.171 (53-474) pg/ml).

The time interval from the onset of symptoms to first blood collection is an important determinant for NT-proBNP values on admission in patients with an ACS and needs to be considered in clinical practice.

Key words: N-terminal pro B-type natriuretic peptide, NT-proBNP, Acute coronary syndromes, Myocardial infarction