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Abstract
The study aimed to evaluate the differences in secretion of NT-proBNP and conventional cardiac markers in patients with STE-ACS vs NSTE-ACS as a trial to solve the dilemma of the early detection of myocardial ischemia in NSTE-ACS. Sixty two patients with acute coronary syndrome (ACS) divided into 2 groups according to ECG: group1 with elevated ST segment in ECG (STE-ACS) and group 2 with non elevated ST segment (NSTE-ACS).Twenty healthy subjects with matched age and sex were enrolled as control group in this study. In the sera of all subjects, levels of NT –proBNP, CK-MB and troponin-T were measured by different kits. CK-MB and TnT were both significantly higher in STE-ACS patients compared to NSTE-ACS patients. Conversely, NT-proBNP was significantly higher in NSTE-ACS patients than STE-ACS especially within 4 hours from onset of chest pain. Comparison between NT-proBNP, TnT and CK-MB levels by ROC curves revealed area under the curves = 0.68, 0.31, 0.17 respectively. NT-proBNP at cutoff 415 pg/mL in NSTE-ACS patients had higher sensitivity and specificity (92%, 39%; respectively) than other markers that will help in earl diagnosis of NSTE-ACS.
Highlights
The serum level of N-terminal B-type natriuretic peptide (NT-proBNP) was elevated in patients with left ventricular (LV) dysfunction and showed a close correlation with the BNP level
The study aimed to evaluate the differences in secretion of NT-proBNP and conventional cardiac markers in patients with ST elevated (STE)-acute coronary syndrome (ACS) vs NSTE-ACS as a trial to solve the dilemma of the early detection of myocardial ischemia in NSTE-ACS
The clinical spectrum of ACS consists of ST elevated (STE) myocardial infarction (MI) (STEMI) and non-STE (NSTE) MI (NSTEMI)/or unstable angina (UA), which are classified from the acute phase electrocardiography (ECG) changes and the development of myocardial necrosis
Summary
The serum level of N-terminal B-type natriuretic peptide (NT-proBNP) was elevated in patients with left ventricular (LV) dysfunction and showed a close correlation with the BNP level. NT-proBNP provided information that may be superior to clinical judgment for the diagnostic evaluation of the patient with possible HF. It was a surrogate biomarker for prognosis of myocardial damage as assessed by contrast-enhanced Cardiac MRI [6]. It was an independent predictor of survival in patients with hypertension and increased left ventricular mass [7]. STEMI caused by acute total coronary occlusion, whereas NSTEMI associated with vulnerable plaque and subocclusive thrombosis [8]
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