El NT-proBNP predice mal pronóstico en pacientes con síndromes coronarios agudos sin elevación del segmento ST y función ventricular conservada

background nt-probnp levels are associated with left ventricular (lv) dysfunction and adverse outcome in non-st-elevation acute coronary syndromes (nste-acs). there is little evidence about the prognostic information of nt-probnp in patients with normal lv function and nste-acs. work objective to assess the prognostic value of nt-probnp in patients with nste-acs and without systolic dysfunction. research design and methods from a cohort of patients with nste-acs who underwent in-hospital angiography, we selected 393 who showed a left ventricular ejection fraction ≥40%. independent core labs analyzed angiograms and nt-probnp, troponin t, myoglobin and c-reactive protein measurements. analyses were performed using a cut-off point of nt-probnp of 586 pg/ml. the primary endpoint was incidence of death or myocardial infarction (mi) at 180 days. results eighty-three patients (21%) had nt-probnp levels ≥586 pg/ ml, and 310 (79%) had nt-probnp levels <586 pg/ml. patients with increased nt-probnp were older and more often females; they showed a higher proportion of elevated serum markers and a higher proportion of extended coronary disease and complex coronary lesions. compared with those with nt-probnp <586 pg/ml, these patients showed higher incidence of death (9.6% vs. 2.3%; p = 0.002), myocardial infarction (9.6% vs. 3.2%; p = 0.01), and death or mi (16.9% vs. 5.5%; p = 0.001) at 180 days. in a multivariate analysis including clinical, ecg and angiographic features, nt-probnp was an independent predictor of total death and death /mi at 6 months. conclusions nt-probnp is an independent predictor of death or myocardial infarction and total death at 6 months in patients with nste-acs and without systolic dysfunction.