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B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina

BACKGROUND: Several mechanisms are involved in the pathophysiology of the Acute Coronary Syndrome (ACS). We have addressed whether B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hsCRP) in admission samples may improve risk stratification in chest pain patients with suspected...

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Autores principales: León de la Fuente, Ricardo, Naesgaard, Patrycja A, Nilsen, Stein Tore, Woie, Leik, Aarsland, Torbjoern, Gallo, Patricio, Grundt, Heidi, Staines, Harry, Nilsen, Dennis WT
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199275/
https://www.ncbi.nlm.nih.gov/pubmed/21958326
http://dx.doi.org/10.1186/1471-2261-11-57
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author León de la Fuente, Ricardo
Naesgaard, Patrycja A
Nilsen, Stein Tore
Woie, Leik
Aarsland, Torbjoern
Gallo, Patricio
Grundt, Heidi
Staines, Harry
Nilsen, Dennis WT
author_facet León de la Fuente, Ricardo
Naesgaard, Patrycja A
Nilsen, Stein Tore
Woie, Leik
Aarsland, Torbjoern
Gallo, Patricio
Grundt, Heidi
Staines, Harry
Nilsen, Dennis WT
author_sort León de la Fuente, Ricardo
collection PubMed
description BACKGROUND: Several mechanisms are involved in the pathophysiology of the Acute Coronary Syndrome (ACS). We have addressed whether B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hsCRP) in admission samples may improve risk stratification in chest pain patients with suspected ACS. METHODS: We included 982 patients consecutively admitted with chest pain and suspected ACS at nine hospitals in Salta, Northern Argentina. Total and cardiac mortality were recorded during a 2-year follow up period. Patients were divided into quartiles according to BNP and hsCRP levels, respectively, and inter quartile differences in mortality were statistically evaluated applying univariate and multivariate analyses. RESULTS: 119 patients died, and the BNP and hsCRP levels were significantly higher among these patients than in survivors. In a multivariable Cox regression model for total death and cardiac death in all patients, the hazard ratio (HR) in the highest quartile (Q4) as compared to the lowest quartile (Q1) of BNP was 2.32 (95% confidence interval (CI), 1.24-4.35), p = 0.009 and 3.34 (95% CI, 1.26-8.85), p = 0.015, respectively. In the TnT positive patients (TnT > 0.01 ng/mL), the HR for total death and cardiac death in Q4 as compared to Q1 was 2.12 (95% CI, 1.07-4.18), p = 0.031 and 3.42 (95% CI, 1.13-10.32), p = 0.029, respectively. The HR for total death for hsCRP in Q4 as compared to Q1 was 1.97 (95% CI, 1.17-3.32), p = 0.011, but this biomarker did not predict cardiac death (p = 0.21). No prognostic impact of these two biomarkers was found in the TnT negative patients. CONCLUSION: BNP and hsCRP may act as clinically useful biomarkers when obtained at admission in a population with suspected ACS. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01377402.
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spelling pubmed-31992752011-10-24 B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina León de la Fuente, Ricardo Naesgaard, Patrycja A Nilsen, Stein Tore Woie, Leik Aarsland, Torbjoern Gallo, Patricio Grundt, Heidi Staines, Harry Nilsen, Dennis WT BMC Cardiovasc Disord Research Article BACKGROUND: Several mechanisms are involved in the pathophysiology of the Acute Coronary Syndrome (ACS). We have addressed whether B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hsCRP) in admission samples may improve risk stratification in chest pain patients with suspected ACS. METHODS: We included 982 patients consecutively admitted with chest pain and suspected ACS at nine hospitals in Salta, Northern Argentina. Total and cardiac mortality were recorded during a 2-year follow up period. Patients were divided into quartiles according to BNP and hsCRP levels, respectively, and inter quartile differences in mortality were statistically evaluated applying univariate and multivariate analyses. RESULTS: 119 patients died, and the BNP and hsCRP levels were significantly higher among these patients than in survivors. In a multivariable Cox regression model for total death and cardiac death in all patients, the hazard ratio (HR) in the highest quartile (Q4) as compared to the lowest quartile (Q1) of BNP was 2.32 (95% confidence interval (CI), 1.24-4.35), p = 0.009 and 3.34 (95% CI, 1.26-8.85), p = 0.015, respectively. In the TnT positive patients (TnT > 0.01 ng/mL), the HR for total death and cardiac death in Q4 as compared to Q1 was 2.12 (95% CI, 1.07-4.18), p = 0.031 and 3.42 (95% CI, 1.13-10.32), p = 0.029, respectively. The HR for total death for hsCRP in Q4 as compared to Q1 was 1.97 (95% CI, 1.17-3.32), p = 0.011, but this biomarker did not predict cardiac death (p = 0.21). No prognostic impact of these two biomarkers was found in the TnT negative patients. CONCLUSION: BNP and hsCRP may act as clinically useful biomarkers when obtained at admission in a population with suspected ACS. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT01377402. BioMed Central 2011-09-29 /pmc/articles/PMC3199275/ /pubmed/21958326 http://dx.doi.org/10.1186/1471-2261-11-57 Text en Copyright ©2011 de la Fuente et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
León de la Fuente, Ricardo
Naesgaard, Patrycja A
Nilsen, Stein Tore
Woie, Leik
Aarsland, Torbjoern
Gallo, Patricio
Grundt, Heidi
Staines, Harry
Nilsen, Dennis WT
B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina
title B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina
title_full B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina
title_fullStr B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina
title_full_unstemmed B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina
title_short B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina
title_sort b-type natriuretic peptide and high sensitive c-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from salta, argentina
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3199275/
https://www.ncbi.nlm.nih.gov/pubmed/21958326
http://dx.doi.org/10.1186/1471-2261-11-57
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