Aspromonte Nadia, Di Fusco Stefania A, Latini Roberto, Cruz Dinna N, Masson Serge, Tubaro Marco, Palazzuoli Alberto
Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy.
Coron Artery Dis. 2013 Jan;24(1):33-9. doi: 10.1097/MCA.0b013e32835b6741.
Plasma levels of natriuretic peptides (NPs) appear to have an important prognostic value in many clinical settings including coronary artery disease and provide additional information about cardiovascular risk.
The aim of this study was to review the literature on the role of NPs in the prognosis and management of patients with acute chest pain and acute coronary syndrome (ACS). Several trials have assessed the prognostic value of NPs as biomarkers of myocardial injury for risk stratification in patients with acute chest pain and ACS. The additional prognostic information on measurement of NP levels is independent of that provided by cardiac troponin and the various clinical and ECG features and traditional risk markers available at hospital admission.
Although measurement of the level of NPs is not recommended as a diagnostic tool in ACS management, their concentrations seem to distinguish patients at a higher risk not only for heart failure but also for ACS. NPs are a good risk marker for ACS, in addition to troponins, but have not yet been proved suitable for guiding therapy.
在包括冠状动脉疾病在内的许多临床环境中，利钠肽（NPs）的血浆水平似乎具有重要的预后价值，并提供有关心血管风险的额外信息。
本研究的目的是回顾关于NPs在急性胸痛和急性冠状动脉综合征（ACS）患者的预后和管理中的作用的文献。几项试验评估了NPs作为心肌损伤生物标志物对急性胸痛和ACS患者进行风险分层的预后价值。关于NP水平测量的额外预后信息独立于心肌肌钙蛋白以及入院时可用的各种临床和心电图特征及传统风险标志物所提供的信息。
尽管不建议将NPs水平测量作为ACS管理中的诊断工具，但它们的浓度似乎不仅能区分出心力衰竭风险较高的患者，还能区分出ACS风险较高的患者。除肌钙蛋白外，NPs是ACS的良好风险标志物，但尚未被证明适用于指导治疗。
