Pathophysiology, prognostic significance and clinical utility of B-type natriuretic peptide in acute coronary syndromes

Stephen D. Wiviott, James A de Lemos, David A. Morrow

Research output: Contribution to journalArticle

39 Citations (Scopus)

Abstract

The natriuretic hormones are a family of vasoactive peptides that can be measured circulating in the blood. Because they serve as markers of hemodynamic stress, the major focus of the use of natriuretic peptide levels [predominantly B-type natriuretic peptide (BNP) and N-terminal (NT)-pro-BNP] has been as an aid to the clinical diagnosis and management of congestive heart failure (CHF). Recently, however, the measurement of natriuretic peptides in the acute coronary syndromes (ACS) has been shown to provide information complementary to traditional biomarkers (of necrosis) such as cardiac troponins and creatine kinase (CK). Studies in several types of acute coronary syndromes [ST-segment elevation myocardial infarction (STEMI), non-ST elevation MI (NSTEMI) and unstable angina (UA)] have shown that elevated levels of natriuretic peptides are independently associated with adverse outcomes, particularly mortality. Additional information is obtained from the use natriuretic peptides in combination with other markers of risk including biomarkers of necrosis and inflammation. This review will summarize the scientific rationale and clinical evidence supporting measurement of natriuretic peptides for risk stratification in acute coronary syndromes. Future research is needed to identify therapies of particular benefit for patients with ACS and natriuretic peptide elevation.

Original languageEnglish (US)
Pages (from-to)119-128
Number of pages10
JournalClinica Chimica Acta
Volume346
Issue number2
DOIs
StatePublished - Aug 16 2004

Fingerprint

Natriuretic Peptides
Brain Natriuretic Peptide
Acute Coronary Syndrome
Biomarkers
Necrosis
Natriuretic Agents
Troponin
Unstable Angina
Hemodynamics
Creatine Kinase
Blood
Heart Failure
Inflammation
Peptides
Mortality

Keywords

  • Acute coronary syndrome
  • ANP
  • BNP
  • Myocardial infarction
  • Natriuretic peptides
  • NT-pro-BNP
  • Review
  • Unstable angina

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry

Cite this

Pathophysiology, prognostic significance and clinical utility of B-type natriuretic peptide in acute coronary syndromes. / Wiviott, Stephen D.; de Lemos, James A; Morrow, David A.

In: Clinica Chimica Acta, Vol. 346, No. 2, 16.08.2004, p. 119-128.

Research output: Contribution to journalArticle

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