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NT-proBNP in unstable coronary artery disease: experiences from the FAST, GUSTO IV and FRISC II trials
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Kardiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Kardiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Kardiologi)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. (Clinical Chemistry)
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2004 (English)In: European Journal of Heart Failure, ISSN 1388-9842, E-ISSN 1879-0844, Vol. 6, no 3, 319-325 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Risk stratification is important in patients with unstable coronary artery disease (CAD), i.e. unstable angina or non-ST-elevation myocardial infarction. This article focuses on the emerging role of N-terminal pro brain natriuretic peptide (NT-proBNP) and the results from the FAST, GUSTO IV and FRISC II trials.

METHODS: In the FAST study, NT-proBNP was measured on admission in 755 patients admitted because of symptoms suggestive of unstable CAD. Follow up was performed after 40 months. The GUSTO IV and the FRISC II-trials included patients with unstable CAD and NT-proBNP was analyzed in 6806 and 2019 patients, with follow up after 1 and 2 years, respectively.

RESULTS: In the FAST study, patients in the 2nd, 3rd, and 4th NT-proBNP quartile had a relative risk of subsequent death of 4.2 (1.6-11.1), 10.7 (4.2-26.8) and 26.6 (10.8-65.5), respectively. In the GUSTO IV trial, increasing quartiles of NT-proBNP were related to short and long term mortality which at 1 year was; 1.8%, 3.9%, 7.7% and 19.2% (P<0.001), respectively. In multivariable analyses including well-known predictors of outcome, NT-proBNP level was independently associated to mortality in all three studies. In the FRISC II trial, the NT-proBNP level, especially if combined with a marker of inflammation, identified those with the greatest benefit from an early invasive strategy.

CONCLUSION: NT-proBNP is strongly associated with mortality in patients with suspected or confirmed unstable CAD and, combined with a marker of inflammation, seems helpful in identifying those with greatest benefit from an early invasive strategy.

Place, publisher, year, edition, pages
2004. Vol. 6, no 3, 319-325 p.
Keyword [en]
Aged, Angina; Unstable/blood/*mortality, Biological Markers/blood, Clinical Trials, Humans, Myocardial Infarction/blood/*mortality, Nerve Tissue Proteins/*blood, Peptide Fragments/*blood, Survival Analysis
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Medical and Health Sciences
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URN: urn:nbn:se:uu:diva-71575DOI: 10.1016/j.ejheart.2004.01.007PubMedID: 14987583OAI: oai:DiVA.org:uu-71575DiVA: diva2:99486
Available from: 2005-09-06 Created: 2005-09-06 Last updated: 2017-11-21Bibliographically approved

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James, StefanLindahl, BertilStridsberg, MatsVenge, PerWallentin, Lars

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