Prognostic value of plasma brain natriuretic peptide and C-reactive protein in patients with acute coronary syndromes underwent percutaneous coronary intervention
He, B.; Ding, S.; Pu, J.; Liu, J-ping.; Song, W.; Du, Y-ping.; Shen, J-yan.; Jin, S-xuan.; Sun, Y.; Shen, L.
Zhonghua Xin Xue Guan Bing Za Zhi 34(4): 349-352
2006
ISSN/ISBN: 0253-3758 PMID: 16776932 Document Number: 601410
Objective To evaluate the prognostic value of plasma brain natriuretic peptide (BNP) and C-reactive protein (CRP) in patients with acute coronary syndromes (ACS) underwent percutaneous coronary intervention (PCI). Methods Patients with ACS underwent PCI in our hospital from December 2004 to September 2005 were included in this study. Plasma BNP (n = 189) and CRP (n = 141) were measured at a median of (34.2 +/- 16.3) hours from symptom onset, total mortality and the risk for major adverse cardiac events (MACE, including death, recurrent MI, recurrent angina, heart failure, readmission for any reason) at 30 days and at 3 months was analyzed. Results Patients were divided into 4 groups according to their BNP levels (BNP <= 100 ng/L, BNP > 100 ng/L to <= 300 ng/L, BNP > 300 ng/L to <= 600 ng/L and BNP > 600 ng/L) and the 3-month mortality was 0%, 1.4%, 7.7%, 48.3% and 3-month incidence of MACE was 7.9%, 17.1%, 57.7%, 79.3% respectively. Multivariate logistic regression analyses showed that the plasma BNP level predicted 30-day (r = 0.8515, P < 0.01) and 3-month (r = 0.9201, P < 0.01) mortality and 30-day (r = 0.7066, P < 0.01) and 3-month (r = 9.7090, P < 0.01 incidence of MACE independent of other known prognostic factors such as age, gender, family heredity, hypercholesterolemia diabetes, hypertension, smoking and LVEF. Patients were divided into 3 groups according to their CRP levels (CRP <= 8. 0 mg/L, CRP > 8.0 mg/L to > 32.0 mg,/L, CRP >32.0 mg/L) and 3-month mortality was 2.7%, 7.7% and 28. 6% and 3-month incidence of MACE was 28.4%, 41. 0% and 60. 7% respectively. CRP predicted 30-day (r = 0. 5882, P = 0. 0044) and 3-month (r = 0. 5235 9 P = 0. 0038) mortality independent of traditional risk factors, and predicted 30-day ( r = 0. 2705, P = 0. 0380) and 3-month (r = 0. 2290, P = 0. 0429) incidence of MACE after adjustment for patient age. CRP lost its predictive value after BNP was introduced into the model, while BNP was still an independent predictor for mortality and incidence of MACE at 30 days and 3 months in ACS patients underwent PCI. Conclusion Both plasma BNP and CRP are good predictors for early mortality and MACE incidence in ACS patients underwent PCI.