Difference in Elevation of N-Terminal Pro-BNP and Conventional Cardiac Markers Between Patients With ST Elevation vs Non-ST Elevation Acute Coronary Syndrome
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概要
- 論文の詳細を見る
Background N-terminal pro-B-type natriuretic peptide (NT-proBNP) is elevated in patients with acute coronary syndrome (ACS), and is a powerful predictor of long-term mortality. Differences in the clinical utility and pathophysiological implication of NT-proBNP and conventional cardiac markers in patients with ST elevation (STE) vs non-STE (NSTE) ACS were investigated in the present study. Methods and Results Ninety consecutive patients admitted with acute chest pain and a diagnosis of unstable angina or acute myocardial infarction were analyzed. Patients with ≥Killip class II were excluded to focus on the effect of myocardial ischemia on the release of cardiac markers. The markers were measured on admission and analyzed according to the time from onset. Conventional cytosolic marker (creatine kinase-MB) and myofibril marker (troponin T: TnT) were both significantly higher in STE-ACS patients compared with NSTE-ACS patients. Conversely, NT-proBNP was significantly higher in NSTE-ACS patients than STE-ACS especially within 3 h of onset, suggesting a larger ischemic insult despite the smaller extent of myocardial necrosis compared with STE-ACS patients. There was no significant correlation between NT-proBNP level and left ventricular ejection fraction (LVEF) obtained at acute-phase echocardiography in either NSTE-ACS patients (LVEF 57.7±11.2%) or STE-ACS patients (LVEF 55.1±12.7%). Comparison between NT-proBNP and TnT levels revealed a marked difference of elevations, with significantly augmented elevation of NT-proBNP (p<0.001) in NSTE-ACS patients as compared with prominent elevation of TnT in STE-ACS patients. Conclusions NT-proBNP is an early sensitive marker of myocardial ischemia that rises much higher in the earlier phase as compared with conventional markers of myocardial damage, especially in NSTE-ACS patients.
- 社団法人日本循環器学会の論文
- 2006-10-20
著者
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Sawa Yoshiki
Department Of Cardiovascular Surgery Osaka Graduate School Of Medicine
-
Takano T
Intensive & Cardiac Care Unit Nippon Medical School
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Seino Yoshihiko
Cardiovascular Center Chiba-hokusoh Hospital Nippon Medical School
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Takayama Tadateru
Tokyo CCU Network Scientific Committee
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Takano Teruo
Tokyo CCU network Scientific Committee
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Takano Teruo
The First Department of Internal Medicine, Nippon Medical School
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Ogawa Akio
The First Department of Internal Medicine (Department of Cardiology), Nippon Medical School
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Seino Yoshihiko
The First Department of Internal Medicine (Department of Cardiology), Nippon Medical School
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Yamashita Teruyo
The First Department of Internal Medicine (Department of Cardiology), Nippon Medical School
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Ogata Ken-ichi
The First Department of Internal Medicine (Department of Cardiology), Nippon Medical School
-
Takano Teruo
日本医科大学附属第二病院 健康管理科
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Ogawa Akio
Department Of Cardiology Nippon Medical School
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Sakata Y
Cardiovascular Center Chiba-hokusoh Hospital Nippon Medical School
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Takano Teruo
Division Of Cardiology Hepatology Geriatrics And Integrated Medicine Department Of Internal Medicine
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Ogata Ken-ichi
The First Department Of Internal Medicine (department Of Cardiology) Nippon Medical School
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Ogata Kenichi
Department Of Internal Medicine And Cardiology Tama-nagayama Hospital Nippon Medical School
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Takano Teruo
The First Department Of Internal Medicine Nippon Medical School
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Yamashita Teruyo
Department Of Cardiology Nippon Medical School
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Takano Teruo
Department Of Lnternal Medicine Nippon Medical School
-
Seino Yoshihiko
First Department Of Internal Medicine Nippon Medical School
-
Takano Teruo
Department Of Internal Medicine (division Of Cardiology Hepatology Geriatrics And Integrated Medicin
-
Seino Yoshihiko
Department Of Internal Medicine And Cardiovascular Center Nippon Medical School Chiba-hokusoh Hospit
-
Seino Yoshihiko
The First Department Of Internal Medicine
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TAKANO Teruo
The First Department of Internal Medicine and Coronary Care Unit, Nippon Medical School
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