Temporal Biomarker Profiling Reveals Longitudinal Changes in Risk of Death or Myocardial Infarction in Non-ST-Segment Elevation Acute Coronary Syndrome

Clinical Chemistry
Mark Y ChanTRILOGY ACS Investigators

Abstract

There are conflicting data on whether changes in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) concentrations between time points (delta NT-proBNP and hs-CRP) are associated with a change in prognosis. We measured NT-proBNP and hs-CRP at 3 time points in 1665 patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). Cox proportional hazards was applied to the delta between temporal measurements to determine the continuous association with cardiovascular events. Effect estimates for delta NT-proBNP and hs-CRP are presented per 40% increase as the basic unit of temporal change. Median NT-proBNP was 370.0 (25th, 75th percentiles, 130.0, 996.0), 340.0 (135.0, 875.0), and 267.0 (111.0, 684.0) ng/L; and median hs-CRP was 4.6 (1.7, 13.1), 1.9 (0.8, 4.5), and 1.8 (0.8, 4.4) mg/L at baseline, 30 days, and 6 months, respectively. The deltas between baseline and 6 months were the most prognostically informative. Every +40% increase of delta NT-proBNP (baseline to 6 months) was associated with a 14% greater risk of cardiovascular death (adjusted hazard ratio (HR) 1.14, 95% CI, 1.03-1.27) and with a 14% greater risk of all-cause death (adjusted HR 1.14, 95% CI, 1.04-1....Continue Reading

References

Nov 10, 2004·Circulation·Christopher HeeschenUNKNOWN Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Investigators
Jan 26, 2005·Archives of Internal Medicine·Peter BogatyGilles R Dagenais
Dec 15, 2005·JAMA : the Journal of the American Medical Association·David A MorrowUNKNOWN Investigators
Jul 11, 2006·European Journal of Heart Failure·Morten SchouPer R Hildebrandt
Sep 5, 2006·Journal of the American College of Cardiology·Cynthia M WesterhoutUNKNOWN GUSTO-IV ACS Trial Investigators
Oct 24, 2006·The American Journal of Cardiology·José Paulo AraújoPaulo Bettencourt
Jan 16, 2007·European Heart Journal·Morten SchouPer R Hildebrandt
Jul 7, 2009·European Heart Journal·François SchieleUNKNOWN Reseau de Cardiologie de Franche Comte
Jul 18, 2009·Journal of the American College of Cardiology·Kai M EggersBertil Lindahl
Aug 28, 2012·The New England Journal of Medicine·Matthew T RoeUNKNOWN TRILOGY ACS Investigators
Nov 3, 2012·JAMA : the Journal of the American Medical Association·Paul A GurbelUNKNOWN TRILOGY ACS Platelet Function Substudy Investigators

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