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BMC Cardiovascular Disorders
Published in: BMC Cardiovascular Disorders 1/2011

Open Access 01-12-2011 | Research article

B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina

Authors: Ricardo León de la Fuente, Patrycja A Naesgaard, Stein Tore Nilsen, Leik Woie, Torbjoern Aarsland, Patricio Gallo, Heidi Grundt, Harry Staines, Dennis WT Nilsen

Published in: BMC Cardiovascular Disorders | Issue 1/2011

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Abstract

Background

Several mechanisms are involved in the pathophysiology of the Acute Coronary Syndrome (ACS). We have addressed whether B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hsCRP) in admission samples may improve risk stratification in chest pain patients with suspected ACS.

Methods

We included 982 patients consecutively admitted with chest pain and suspected ACS at nine hospitals in Salta, Northern Argentina. Total and cardiac mortality were recorded during a 2-year follow up period. Patients were divided into quartiles according to BNP and hsCRP levels, respectively, and inter quartile differences in mortality were statistically evaluated applying univariate and multivariate analyses.

Results

119 patients died, and the BNP and hsCRP levels were significantly higher among these patients than in survivors. In a multivariable Cox regression model for total death and cardiac death in all patients, the hazard ratio (HR) in the highest quartile (Q4) as compared to the lowest quartile (Q1) of BNP was 2.32 (95% confidence interval (CI), 1.24-4.35), p = 0.009 and 3.34 (95% CI, 1.26-8.85), p = 0.015, respectively. In the TnT positive patients (TnT > 0.01 ng/mL), the HR for total death and cardiac death in Q4 as compared to Q1 was 2.12 (95% CI, 1.07-4.18), p = 0.031 and 3.42 (95% CI, 1.13-10.32), p = 0.029, respectively.
The HR for total death for hsCRP in Q4 as compared to Q1 was 1.97 (95% CI, 1.17-3.32), p = 0.011, but this biomarker did not predict cardiac death (p = 0.21). No prognostic impact of these two biomarkers was found in the TnT negative patients.

Conclusion

BNP and hsCRP may act as clinically useful biomarkers when obtained at admission in a population with suspected ACS.

Trial Registration

ClinicalTrials.gov Identifier: NCT01377402.
Appendix
Available only for authorised users
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Metadata
Title
B-type natriuretic peptide and high sensitive C-reactive protein predict 2-year all cause mortality in chest pain patients: a prospective observational study from Salta, Argentina
Authors
Ricardo León de la Fuente
Patrycja A Naesgaard
Stein Tore Nilsen
Leik Woie
Torbjoern Aarsland
Patricio Gallo
Heidi Grundt
Harry Staines
Dennis WT Nilsen
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Cardiovascular Disorders / Issue 1/2011
Electronic ISSN: 1471-2261
DOI
https://doi.org/10.1186/1471-2261-11-57

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