Propéptido natriurético tipo B N-terminal: un predictor de mal pronóstico en síndromes coronarios sin elevación del segmento ST

background brain natriuretic peptide (bnp) is a strong predictor of adverse outcomes in patients with acute coronary syndromes. therefore, it is expected that n terminal pro b type natriuretic peptide (nt pro-bnp) should be a useful early risk stratification marker in this setting. research design and methods we measured nt pro-bnp, troponin t, ck-mb mass, c reactive protein and myoglobin in serum samples obtained from 254 patients enrolled in a prospective multicentric cohort of non st-segment elevation coronary syndrome patients. primary end point was 30-day mortality. results the overall 30-day mortality rate was 3.8%. nt pro-bnp levels were measured in samples obtained at a median time of 4.9 hours (from admission) and at a median time of 12 hours. nt pro-bnp concentration was significantly lower in patients who survived (392.5 pg/ml) than in those who died (2706 pg/ml), p = 0.003. stepwise logistic regression analysis including significant predictors (st deviation and elevated markers) showed that both admission nt pro-bnp levels (or 5 [95% ci: 1-24.9] p = 0.04) and 12 hs nt pro-bnp levels (or 3.4 [95% ci: 1.1-9.7] p = 0.02) were independent predictors of 30- day mortality. conclusion nt pro-bnp is an early and independent predictor of adverse short-term outcome in patients with non st-segment elevation coronary syndromes.