Omland Torbjørn
Professor of Medicine, Department of Medicine, Akershus University Hospital, University of Oslo, NO-1478 Lørenskog, Norway.
Expert Rev Mol Diagn. 2008 Mar;8(2):217-25. doi: 10.1586/14737159.8.2.217.
Circulating concentrations of B-type natriuretic peptide (BNP) and the N-terminal fragment (NT) of its prohormone (proBNP) are related to cardiac function and have emerged as clinically useful tools for the diagnosis of heart failure and for the estimation of prognosis in patients with heart failure and acute coronary syndromes. Recent studies have also convincingly documented that both BNP and NT-proBNP are powerful, independent prognostic indicators in patients with stable coronary artery disease. The associations are strongest for the end-points of death and heart failure, whereas the association with cardiac ischemic events is weaker or nonexistent, after adjustment for confounding factors. Importantly, BNP and NT-proBNP appear to provide incremental prognostic information to conventional risk factors, including markers of ventricular function and ischemia. Data documenting that BNP or NT-proBNP measurements can be used to guide treatment decisions in patients with stable coronary artery disease are still lacking.
B型利钠肽（BNP）及其前体激素（proBNP）的N末端片段（NT）的循环浓度与心功能相关，并已成为诊断心力衰竭以及评估心力衰竭和急性冠状动脉综合征患者预后的临床有用工具。最近的研究也令人信服地证明，BNP和NT-proBNP在稳定型冠状动脉疾病患者中都是强大的独立预后指标。在调整混杂因素后，这些关联在死亡和心力衰竭终点方面最强，而与心脏缺血事件的关联较弱或不存在。重要的是，BNP和NT-proBNP似乎能为包括心室功能和缺血标志物在内的传统危险因素提供额外的预后信息。目前仍缺乏关于BNP或NT-proBNP测量可用于指导稳定型冠状动脉疾病患者治疗决策的数据。
