alexa The prognostic value of N-terminal pro-brain natriuretic peptide in non-ST elevation acute coronary syndromes: a meta-analysis.
Cardiology

Cardiology

Angiology: Open Access

Author(s): Zeng X, Li L, Su Q

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Abstract BACKGROUND: Precise risk stratification is important in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) on determination for hospitalization and intensity of treatment. A meta-analysis was performed in studies of patients with NSTE-ACS to evaluate the predictive nature of elevated N-terminal pro-brain natriuretic peptide (NT-proBNP). METHODS: Online searches were conducted using database to identify suitable studies. A summary of relative risks (RRs) for death and myocardial infarction (MI) was calculated using random-effects modeling. We also calculated the pooled sensitivity, specificity, positive predictive value, and negative predictive value. RESULTS: Thirteen studies were included. Elevated NT-proBNP levels were significantly associated with mortality [RR 4.89; 95\% confidence interval (CI) 3.85–6.22] and incidence of MI (RR 1.66; 95\% CI 1.24–2.22). The sensitivity and specificity for MI was 69.1\% (95\% CI 66.6\%–71.6\%) and 43.6\% (95\% CI 42.9\%–44.3\%), respectively, along with the positive and negative predictive values for MI of 8.2\% (95\% CI 7.7\%–8.7\%) and 95.1\% (95\% CI 94.6\%–95.5\%), respectively. CONCLUSIONS: Meta-analysis suggests that elevated NT-proBNP levels were associated with an increased risk for MI or death in patients with NSTE-ACS. Normal levels of NT-proBNP are certainly more helpful when selecting NSTE-ACS patients with likelihood for favorable outcomes.
This article was published in Clin Chem Lab Med and referenced in Angiology: Open Access

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