Arjol Bilda González

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Laura M. Reyes

Universidad de la República

Eduardo Perna

Instituto Cardiovascular de Buenos Aires

María Lorena Coronel

Centro Científico Tecnológico - Nordeste

Juan Manuel Lange

Hôpital Necker-Enfants Malades

Mónica Brizuela

Hospital El Cruce

Mariela Onocko

Luciana Borgo

Stella M. Macı́n

Argentine Water and Sanitation (Argentina)

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National University of the Northeast

Centro Científico Tecnológico - Nordeste

Instituto de Cardiología y Cirugía Cardiovascular

Instituto Cardiovascular de Buenos Aires

Argentine Water and Sanitation (Argentina)

Universidad de la República

Hospital de Clínicas

Los Algarrobos Observatory

University of Alberta

Women and Children’s Health Research Institute

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Mediciones seriadas de NT-proBNP en síndrome coronario agudo: ¿marcador de riesgo?

Revista de la Federación Argentina de Cardiología (2017)

Stella M. Macı́n Laura M. Reyes Juan Manuel Lange Arjol Bilda González Mariela Onocko

Increases in NT-ProBNP are markers of parietal stress and are caused by different mechanisms. Objective: To evaluate serial measurements of NT-proBNP in ACS and its relation to prognosis. Methods: Observational, prospective study that included 205 consecutive patients with acute coronary syndrome, hospitalized at the Institute of Cardiology of Corrientes from 01-JAN-2010 to 15-JAN-2011. The clinical, electrocardiographic, echocardiographic variables were assessed at baseline and one year. Blood samples were taken at baseline, 1 month, 6 months and 1 year, measuring NT-proBNP. Multivariate analysis was performed. Results: 25 pts (12.2%) unstable angina, 85 pts non-STEMI (41.4%) and 95 pts STEMI (46.4%). The mean age was 62.4±18 years, 78% male. The NT-proBNP values are shown in the attached Table. There was a significant diference between NT-proBNP at the baseline and at 1 month (p<0.001), 1 month to 6 months (p<0.001) and 6 months to 1 year (p<0.001). A multivariate model was constructed to see predictors in follow-up: troponin T persisted as an independent variable in the analysis, HR 3.5 (95%, CI 2.5-4.3), together with HF HR 3.2 (CI 95% 2.1-4.5), age HR 1.15 (CI 95%, 1.05-1.19) and NT-proBNP: HR 2.9 (IC 95%, 2.3-4.15). When ventricular remodeling was analyzed, a drop in ejection fraction (55.72 to 53.50%) was observed in patients in whom NT-proBNP levels remained high, p=0.01; and the diameter of the end of diastole increased (48.08 to 49.61 mm) p=0.03. The 2-year survival in patients who had 2 or more elevated NT-proBNP monitoring was 84% vs 92% for those with <2 determinations of elevated NT-proBNP (p=0.01). Conclusions: Patients with ACS who had 2 or more elevated NT-proBNP measurements had poor prognosis, related with ventricular remodeling manifested by lower ejection fraction and greater diameter of the left ventricle. Pro-BNP is an independent predictor of mortality during the follow-up.

Troponin T

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