Very Long-Term Prognostic Role of Admission BNP in Non-ST Segment Elevation Acute Coronary Syndrome

Abstract Background: BNP has been extensively evaluated to determine short- and intermediate-term prognosis in patients with acute coronary syndrome, but its role in long-term mortality is not known. Objective: To determine the very long-term prognostic role of B-type natriuretic peptide (BNP) for all-cause mortality in patients with non-ST segment elevation acute coronary syndrome (NSTEACS). Methods: A cohort of 224 consecutive patients with NSTEACS, prospectively seen in the Emergency Department, had BNP measured on arrival to establish prognosis, and underwent a median 9.34-year follow-up for all-cause mortality. Results: Unstable angina was diagnosed in 52.2%, and non-ST segment elevation myocardial infarction, in 47.8%. Median admission BNP was 81.9 pg/mL (IQ range = 22.2; 225) and mortality rate was correlated with increasing BNP quartiles: 14.3; 16.1; 48.2; and 73.2% (p < 0.0001). ROC curve disclosed 100 pg/mL as the best BNP cut-off value for mortality prediction (area under the curve = 0.789, 95% CI= 0.723-0.854), being a strong predictor of late mortality: BNP < 100 = 17.3% vs. BNP ≥ 100 = 65.0%, RR = 3.76 (95% CI = 2.49-5.63, p < 0.001). On logistic regression analysis, age >72 years (OR = 3.79, 95% CI = 1.62-8.86, p = 0.002), BNP ≥ 100 pg/mL (OR = 6.24, 95% CI = 2.95-13.23, p < 0.001) and estimated glomerular filtration rate (OR = 0.98, 95% CI = 0.97-0.99, p = 0.049) were independent late-mortality predictors. Conclusions: BNP measured at hospital admission in patients with NSTEACS is a strong, independent predictor of very long-term all-cause mortality. This study allows raising the hypothesis that BNP should be measured in all patients with NSTEACS at the index event for long-term risk stratification.

role of RIP-1 and cIAPs in apoptotic and non-apoptotic signalling via TLR3 and death receptors

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2011

role of Gadd45β in apoptosis and autophagy

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2013

Assessing the role of Piccolo and Bassoon zinc finger domains on synapse vesicle recycling and maintenance

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2013

Neural correlates of context-dependent memory : the role of the insula in episodic encoding and recognition memory ; an fMRI experiment

Magdeburg, Univ., Med. Fak., Diss., 2014

Functional studies on the role of I[Kappa]B NS in T helper cell differentiation

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2014

mRNA metabolism: nonsense mediated mRNA decay as a tool for gene therapy and the role of human DIS3L2 in transcript degradation

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Auditory gating in the ventral striatum and auditory cortex : the role of stimulus-locking and the influence of discrimination learning

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2014

Role of the neurotransmitters dopamine and acetylcholine during the interaction of working memory and attention

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2015

role of NMDA-receptors (NMDARs) and NMDAR antagonists in murine T- and B-lymphocyte function

Magdeburg, Univ., Fak. für Naturwiss., Diss., 2015

role of cFLIP in regulatory T cell homeostasis

Otto-von-Guericke-Universität Magdeburg, Fakultät für Naturwissenschaften, Univ., Dissertation, 2015

role of reactive oxygen species and mitochondria in T-cell activation

Otto-von-Guericke-Universität, Fakultät für Naturwissenschaften, Dissertation, 2016

Security prices and market transparency: the role of prior information

This paper analyzes the role of traders' priors (proper versus improper) on the implications of market transparency by comparing a pre-trade transparent market with an opaque market in a set-up based on Madhavan (1996). We show that prices may be more informative in the opaque market, regardless of how priors are modelled. In contrast, the comparison of market liquidity and volatility in the two market structures are affected by prior specification. Key words: Market microstructure, Transparency, Prior information