• Intern Emerg Med · Dec 2016

    The influence of age on the clinical implications of N-terminal pro-B-type natriuretic peptide in acute coronary syndrome.

    • Fang-Yang Huang, Bao-Tao Huang, Jia-Yu Tsauo, Yong Peng, Tian-Li Xia, Chen Zhang, Rui-Shuang Liu, Zhi-Liang Zuo, Peng-Ju Wang, Yue Heng, Wei Liu, Xiao-Bo Pu, Yi-Yue Gui, Shi-Jian Chen, Yan-Biao Liao, Ye Zhu, and Mao Chen.
    • Department of Cardiology, West China Hospital, Sichuan University, 37 Guoxue Street, Chengdu, 610041, Sichuan, China.
    • Intern Emerg Med. 2016 Dec 1; 11 (8): 107710861077-1086.

    AbstractCurrently, there are no studies addressing the influence of age on the prognostic information of N-terminal pro-B-type natriuretic peptide (NT-proBNP) in Asian population with acute coronary syndrome (ACS). The purpose of this study was to investigate the prognostic performance of NT-proBNP in Chinese patients with ACS across different age groups. A total of 1512 ACS patients with venous blood NT-proBNP measured were enrolled. Patients were divided into tertiles based on their ages (<61, 61-71, ≥72 years). The median NT-proBNP concentrations in the three groups (T1-T3) were 406, 573, and 1288 pg/ml (p < 0.001), respectively. During a median follow-up of 23 months, 150 all-cause deaths occurred, and 88 (58.7 %) were attributed to cardiovascular cause. NT-proBNP levels are independently associated with mortality in each age group [1st group: HR 2.19 95 % CI (1.17-4.10); 2nd group: HR 1.82 95 % CI (1.04-3.20); 3rd group: HR 1.48 95 % CI (1.09-2.01), P interaction = 0.062]. NT-proBNP improves discrimination and reclassification for mortality beyond thrombolysis in myocardial infarction score in patients of all ages. The optimal NT-proBNP cutoff points for predicting mortality in three age groups are 1511, 2340, and 2883 pg/ml, respectively. In conclusion, NT-proBNP is a valuable biomarker in predicting long-term mortality and provides an improvement in discrimination and reclassification for prognosis in ACS patients of all ages.

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