BNP was Associated with Ischemic Myocardial Scintigraphy and Death in Patients at Chest Pain Unit

Background:Recent studies have suggested that B-type Natriuretic Peptide (BNP) is an important predictor of ischemia and death in patients with suspected acute coronary syndrome. Increased levels of BNP are seen after episodes of myocardial ischemia and may be related to future adverse events.Objectives:To determine the prognostic value of BNP for major cardiac events and to evaluate its association with ischemic myocardial perfusion scintigraphy (MPS).Methods:This study included retrospectively 125 patients admitted to the chest pain unit between 2002 and 2006, who had their BNP levels measured on admission and underwent CPM for risk stratification. BNP values were compared with the results of the MPS. The chi-square test was used for qualitative variables and the Student t test, for quantitative variables. Survival curves were adjusted using the Kaplan-Meier method and analyzed by using Cox regression. The significance level was 5%.Results:The mean age was 63.9 ± 13.8 years, and the male sex represented 51.2% of the sample. Ischemia was found in 44% of the MPS. The mean BNP level was higher in patients with ischemia compared to patients with non-ischemic MPS (188.3 ± 208.7 versus 131.8 ± 88.6; p = 0.003). A BNP level greater than 80 pg/mL was the strongest predictor of ischemia on MPS (sensitivity = 60%, specificity = 70%, accuracy = 66%, PPV = 61%, NPV = 70%), and could predict medium-term mortality (RR = 7.29, 95% CI: 0.90-58.6; p = 0.045) independently of the presence of ischemia.Conclusions:BNP levels are associated with ischemic MPS findings and adverse prognosis in patients presenting with acute chest pain to the emergency room, thus, providing important prognostic information for an unfavorable clinical outcome.

Nota preliminar sôbre a variação em orquídeas brasileiras

Preliminary studies on brazilian orchid species show that the existing material offers the possibility for studying the following general questions: a) In spite of the rule about the relative proportion between numbers of individuals per species and number of species per unit area in tropical and in temperate zones, the orchid genera seem to follow more closely the rule of temperate zone species, and this in spite of the fact that the family is undoubtedly of tropical origin. b) The large amont of paralell variation existing between different genera recquires a detailed explanation, and extensive introgressive hybridization is mentioned as one possibility. c) The existence of natural sympatric hybrids, both inter-generic and interspecific, and the simultaneous existence of the species in the pure form, show that mechanismes of reproductive isolation must exist, though of an incomplete nature.

Flora of Peru : Euphorbiaceae, spurge family / J. Francis MacBride.

v.13:pt.3A:no.1 (1951) [Euphorbiaceae]

A revision of the Family Geastraceae.

v.31:no.14(1968)

Family Asteraceae, part V : [tribe Inuleae] / Michael O. Dillon, Abundio Sagástegui Alva.

n.s. no.26(1991)

Flora Costaricensis. William Burger, editor. Family #40, Casuarinaceae, Family #41, PIperaceae [by] William Burger.

v.35(1971)

Flora of Peru: Family compositae : Walter C. Holmes, Sidney McDaniel.

n.s. no.9(1982)

Flora Costaricensis : Family #200, Acanthaceae by L.H. Durkee, Family #201, Plantaginaceae by William Burger.

n.s. no.18(1986)

Austral Hepaticae the genus Balantiopsis in New Zealand, with observations on extraterritorial taxa and a phylogeny of Balantiopsis and the family Balantiopsaceae (Jungermanniales) / John J. Engel, G.L. Smith Merrill.

n.s. no.37(1997)

Family #15, Gramineae / Richard W. Pohl.

n.s. no.4(1980)

Two new rodent genera from the Oligocene White River formation (family Heteromyidae) / William G. Reeder --

v.10:no.35(1960)

A redescription of Amphiprion nigripes Regan, a valid species of anemonefish (family Pomacentridae) from the Indian Ocean [by] Gerald R. Allen and Richard N. Mariscal.

v.58:no.8(1971)

Notes on fishes of the family Hemirhamphidae, by Alfred C. Weed.

v.20:no.7(1933)

Some mites of Yemen collected by the Medical Mission of the United States Naval Medical Research Unit No.3. / Charles D. Radford.

v.34:no.28(1954)