N-terminal Pro B-type Natriuretic Peptide in the Early Evaluation of Suspected Acute Myocardial Infarction

Abstract Background Myocardial ischemia is a strong trigger of N-terminal pro-B-type natriuretic peptide (NT-proBNP) release. As ischemia precedes necrosis in acute myocardial infarction, we hypothesized that NT-proBNP might be useful in the early diagnosis and risk stratification of patients with s...

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Veröffentlicht in:	The American journal of medicine 2011-08, Vol.124 (8), p.731-739
Hauptverfasser:	Haaf, Philip, MD, Balmelli, Cathrin, MD, Reichlin, Tobias, MD, Twerenbold, Raphael, MD, Reiter, Miriam, MD, Meissner, Julia, MD, Schaub, Nora, MD, Stelzig, Claudia, MSc, Freese, Michael, RN, Paniz, Patricia, MD, Meune, Christophe, MD, PhD, Drexler, Beatrice, MD, Freidank, Heike, MD, Winkler, Katrin, MD, Hochholzer, Willibald, MD, Mueller, Christian, MD, FESC
Format:	Artikel
Sprache:	eng
Schlagworte:	Acute chest pain Aged Aged, 80 and over Angina Pectoris - blood Area Under Curve Biological and medical sciences Biomarkers - blood Cardiology Cardiology. Vascular system Clinical outcomes Confounding Factors (Epidemiology) Coronary heart disease Early Diagnosis Female General aspects Heart Heart attacks Humans Internal Medicine International Cooperation Ischemia Male Medical sciences Middle Aged Multivariate Analysis Myocardial Infarction - blood Myocardial Infarction - diagnosis Myocardial Infarction - drug therapy Myocardial Infarction - mortality Myocarditis. Cardiomyopathies Natriuretic Peptide, Brain - blood NT-proBNP Odds Ratio Peptide Fragments - blood Peptides Predictive Value of Tests Prognosis Prospective Studies Risk Assessment Risk Factors Risk stratification ROC Curve Thrombolytic Therapy Treatment Outcome Troponin T - blood
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Zusammenfassung:	Abstract Background Myocardial ischemia is a strong trigger of N-terminal pro-B-type natriuretic peptide (NT-proBNP) release. As ischemia precedes necrosis in acute myocardial infarction, we hypothesized that NT-proBNP might be useful in the early diagnosis and risk stratification of patients with suspected acute myocardial infarction. Methods In a prospective multicenter study, NT-proBNP was measured at presentation in 658 consecutive patients with acute chest pain. The final diagnosis was adjudicated by 2 independent cardiologists. Patients were followed long term regarding mortality. Results Acute myocardial infarction was the adjudicated final diagnosis in 117 patients (18%). NT-proBNP levels at presentation were significantly higher in acute myocardial infarction as compared with patients with other final diagnoses (median 886 pg/mL vs 135 pg/mL, P
ISSN:	0002-9343 1555-7162
DOI:	10.1016/j.amjmed.2011.02.035