High sensitivity C-reactive protein, NT-proBNP and hemodynamic left ventricular function in acute coronary syndrome without ST segment elevation – a preliminary report
Grzegorz Piotrowski, Rafal Gawor, Maciej Banach, Aneta Piotrowska, Jacek Rysz, Zenon Gawor
Med Sci Monit 2010; 16(7): CR313-317
Available online: 2010-06-25
Background: Prognostic factors in acute coronary syndromes have been the subject of interest in cardiology over the last few years. Our study aimed to compare humoral marker concentration shifts (hsCRP, Nt-proBNP) and hemodynamic left ventricular systolic function index changes, determined by means of echocardiography in the first hours of acute coronary syndromes (ACS).
Material/Methods: The study comprised 33 patients with ACS without ST segment elevation. Group I consisted of 18 patients (11 men, 7 women aged from 48 to 77, mean age 67±35 years) with unstable angina pectoris (uAP). Group II consisted of 15 patients (10 men, 5 women aged from 51 to 80, mean age 70±11.9 years) with myocardial infarction without ST segment elevation (NSTEMI). In all patients, Nt-proBNP and hsCRP blood concentrations were determined between the 6th and 12th hours after admission to the intensive coronary care unit. On the 2nd-3rd day, after coronary stabilization, routine echocardiography was performed in each patient to assess left ventricular function.
Results: A positive correlation between hsCRP and Nt-proBNP in uAP was observed in group I. In group II, in patients with NSTEMI no such correlation was observed. There was also no correlation in either study group between humoral (hsCRP and Nt-proBNP) and hemodynamic parameters.
Conclusions: The complex evaluation of the post-ACS prognosis should be multifaceted. It should contain hemodynamic assessment of the left ventricle by means of echocardiography as well as humoral coronary risk markers.
Keywords: Natriuretic Peptide, Brain - blood, Hemodynamics, C-Reactive Protein - metabolism, Aged, 80 and over, Acute Coronary Syndrome - physiopathology, Peptide Fragments - blood, Ventricular Function, Left