Abstract
In addition to their diagnostic and prognostic utility in patients with congestive heart failure, recent data have demonstrated that B-type natriuretic peptide (BNP) and N-terminal- pro (NT-pro)BNP are associated with adverse cardiovascular events in patients presenting with acute coronary syndrome (ACS). Several mechanisms may lead to the elevations seen in plasma levels of these markers in patients with coronary artery disease, including increased left-ventricular wall tension, ischemia, and natriuretic peptide synthesis within atherosclerotic plaues. Despite the robust and consistent association seen in multiple cohorts of ACS patients between elevated levels, and BNP and NTproBNP and mortality and incident heart failure, data defining the optimal treatment strategy for these high-risk patients are limited. Future work is needed to identify the role of BNP and NT-proBNP in the development of ACS risk scores with traditional clinical factors and other biomarkers, and to evaluate the efficacy of different therapeutic measures in improving the prognosis of patients with elevated levels of these peptides.Key WordsAcute coronary syndromerisk stratificationcoronary artery diseasebrain natriuretic peptide
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