PMID- 16251228
OWN - NLM
STAT- MEDLINE
DCOM- 20060619
LR  - 20181113
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Print)
IS  - 1355-6037 (Linking)
VI  - 92
IP  - 6
DP  - 2006 Jun
TI  - Admission N-terminal pro-brain natriuretic peptide and its interaction with 
      admission troponin T and ST segment resolution for early risk stratification in 
      ST elevation myocardial infarction.
PG  - 735-40
AB  - OBJECTIVE: To assess the long term prognostic value of N-terminal pro-brain 
      natriuretic peptide (NT-proBNP) on admission and its prognostic interaction with 
      both admission troponin T (TnT) concentrations and resolution of ST segment 
      elevation in fibrinolytic treated ST elevation myocardial infarction (STEMI). 
      DESIGN AND SETTING: Substudy of the ASSENT (assessment of the safety and efficacy 
      of a new thrombolytic) -2 and ASSENT-PLUS trials. PATIENTS: NT-proBNP and TnT 
      concentrations were determined on admission in 782 patients. According to 
      NT-proBNP concentrations, patients were divided into three groups: normal 
      concentration (for patients < or = 65 years, < or = 184 ng/l and < or = 268 ng/l 
      and for those > 65 years, < or = 269 ng/l and < or = 391 ng/l in men and women, 
      respectively); higher than normal but less than the median concentration (742 
      ng/l); and above the median concentration. For TnT, a cut off of 0.1 microg/l was 
      used. Of the 782 patients, 456 had ST segment resolution (< 50% or > or = 50%) at 
      60 minutes calculated from ST monitoring. MAIN OUTCOME MEASURES: All cause one 
      year mortality. RESULTS: One year mortality increased stepwise according to 
      increasing concentrations of NT-proBNP (3.4%, 6.5%, and 23.5%, respectively, p < 
      0.001). In receiver operating characteristic analysis, NT-proBNP strongly trended 
      to be associated more with mortality than TnT and time to 50% ST resolution (area 
      under the curve 0.81, 95% confidence interval (CI) 0.72 to 0.9, 0.67, 95% CI 0.56 
      to 0.79, and 0.66, 95% CI 0.56 to 0.77, respectively). In a multivariable 
      analysis adjusted for baseline risk factors and TnT, both raised NT-proBNP and ST 
      resolution < 50% were independently associated with higher one year mortality, 
      whereas raised TnT contributed independently only before information on ST 
      resolution was added to the model. CONCLUSION: Admission NT-proBNP is a strong 
      independent predictor of mortality and gives, together with 50% ST resolution at 
      60 minutes, important prognostic information even after adjustment for TnT and 
      baseline characteristics in STEMI.
FAU - Bjorklund, E
AU  - Bjorklund E
AD  - Department of Cardiology, University Hospital of Uppsala, Uppsala, Sweden. 
      erik.bjorklund@akademiska.se
FAU - Jernberg, T
AU  - Jernberg T
FAU - Johanson, P
AU  - Johanson P
FAU - Venge, P
AU  - Venge P
FAU - Dellborg, M
AU  - Dellborg M
FAU - Wallentin, L
AU  - Wallentin L
FAU - Lindahl, B
AU  - Lindahl B
CN  - ASSENT-2 and ASSENT-PLUS Study Groups
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20051026
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
RN  - 0 (Peptide Fragments)
RN  - 0 (Troponin T)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Aged
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*blood/mortality
MH  - Natriuretic Peptide, Brain/*blood
MH  - Patient Admission
MH  - Peptide Fragments/*blood
MH  - Prognosis
MH  - Regression Analysis
MH  - Risk Assessment
MH  - Sensitivity and Specificity
MH  - Survival Analysis
MH  - Troponin T/*blood
PMC - PMC1860646
COIS- Competing interests: None declared.
EDAT- 2005/10/28 09:00
MHDA- 2006/06/20 09:00
PMCR- 2009/06/01
CRDT- 2005/10/28 09:00
PHST- 2005/10/28 09:00 [pubmed]
PHST- 2006/06/20 09:00 [medline]
PHST- 2005/10/28 09:00 [entrez]
PHST- 2009/06/01 00:00 [pmc-release]
AID - hrt.2005.072975 [pii]
AID - ht72975 [pii]
AID - 10.1136/hrt.2005.072975 [doi]
PST - ppublish
SO  - Heart. 2006 Jun;92(6):735-40. doi: 10.1136/hrt.2005.072975. Epub 2005 Oct 26.