N-Terminal B-Type Natriuretic Peptide Assessment Provides Incremental Prognostic Information in Patients With Acute Coronary Syndromes and Normal Troponin T Values Upon Admission

N-Terminal B-Type Natriuretic Peptide Assessment Provides Incremental Prognostic Information in Patients With Acute Coronary Syndromes and Normal Troponin T Values Upon Admission Michael Weber, Oscar Bazzino, Jose L. Navarro Estrada, Juan J. Fuselli, Fernando Botto, Diego Perez de Arenaza, Helge Möllmann, Holger N. Nef, Albrecht Elsässer, Christian W. Hamm We aimed to determine the prognostic value of N-terminal B-type natriuretic peptide (NT-proBNP) in 2,614 troponin negative (troponin T ≤0.01 ng/ml) patients from 2 different registries with evident or suspected acute coronary syndromes (ACS). In these two cohorts, receiver-operating characteristic curve analysis yielded an optimal cutoff value of 474 pg/ml for NT-proBNP that was able to discriminate patients at higher risk in the Bad Nauheim ACS and Prognosis in Acute Coronary Syndromes registries (mortality rate 12.3% vs. 1.3%, p < 0.001 and 8.5% vs. 1.5%, p < 0.001, respectively). Therefore, our study, in combination with previously published data, strongly suggests the implementation of NT-proBNP assessment for risk stratification of patients with chest pain or suspected non–ST-segment elevation ACS and negative troponin values.