Multiparametric evaluation of cardiac risk in acute coronary syndromes: value of biological blood markers
Chapelle, J.P.
Bullet in et Memoires del'Academie Royale de Medecine de Belgique 162(3-4): 207
2007
ISSN/ISBN: 0377-8231 PMID: 18075051 Document Number: 609647
Appropriate evaluation of short- and medium-term cardiovascular risk in acute coronary syndromes (ACS) patients should allow to individualize and improve treatment in the future. Natriuretic peptides can be measured in plasma using reliable and fast methods. B-type natriuretic peptide (BNP) is released into the circulation by the cardiac ventricle in response to increases in wall stress. Both BNP and NT-proBNP have been shown to aid in the diagnosis of heart failure. In addition, these peptides correlate with left ventricular dilatation, remodelling and dysfunction, and have the capacity of improving significantly the early risk stratification in patients with ST- or non-ST-elevation ACS. BNP determinations can be associated to cardiac troponins (for example, cTnT) and C-reactive protein (CRP). Plasma concentrations of these biomarkers are related to different physiopathological mechanisms: tissue necrosis (cTnT), neuro-hormonal activation (BNP, NT-proBNP) or inflammatory process and plaque instability (CRP). Combining two or three of these biomarkers for better risk stratification has the potential to improve substantially the outcomes in patients with ACS.