Mayer Otto, Simon Jaroslav, Plásková Markéta, Cífková Renata, Trefil Ladislav
Second Department of Internal Medicine, Medical Faculty and University Hospital, Charles University, Plzen (Pilsen), Czech Republic.
Eur J Epidemiol. 2009;24(7):363-8. doi: 10.1007/s10654-009-9339-6. Epub 2009 Apr 9.
Brain natriuretic peptide (BNP) and its inactive N-terminal fragment (NT-proBNP) are strong prognostic markers in patients with manifest heart failure and acute coronary syndromes. We aimed to establish the association between NT-proBNP and all-cause mortality in patients with stable chronic coronary heart disease. Three-hundred-eighty-five patients, 6-24 months after acute coronary syndrome or coronary revascularisation, but without history or symptoms of chronic heart failure, were included into the cohort study. The NT-proBNP was measured at baseline and all-cause mortality was ascertained after more than 6 years of follow-up. Patients with NT-proBNP above 862 pmol/l (i.e. in top quintile) showed significantly higher mortality rates, than patients with lower NT-proBNP; the adjusted odds ratio (and 95% confidence intervals) for all-cause death was in patients with NT-proBNP >862 pmol/l 3.26 (1.40-7.62). In conclusion, the asymptomatic elevation of NT-proBNP provides prognostic information also in stable coronary patients not yet manifesting any symptoms of heart failure.
脑钠肽（BNP）及其无活性的N末端片段（NT-proBNP）是明显心力衰竭和急性冠状动脉综合征患者的强有力预后标志物。我们旨在确定NT-proBNP与稳定型慢性冠心病患者全因死亡率之间的关联。385例患者在急性冠状动脉综合征或冠状动脉血运重建后6至24个月，但无慢性心力衰竭病史或症状，被纳入队列研究。在基线时测量NT-proBNP，并在随访6年以上后确定全因死亡率。NT-proBNP高于862 pmol/l（即处于最高五分位数）的患者显示出比NT-proBNP较低的患者显著更高的死亡率；NT-proBNP>862 pmol/l的患者全因死亡的调整优势比（及95%置信区间）为3.26（1.40 - 7.62）。总之，NT-proBNP的无症状升高在尚未出现任何心力衰竭症状的稳定型冠心病患者中也提供了预后信息。
