NT-PROBNP, AND NOT TF, FM, PAPP-A, MPO OR CD40 LIGAND, PREDICTS RECURRENT TROPONIN-T POSITIVE CARDIAC EVENTS FOLLOWING AN ACUTE MYOCARDIAL INFARCTION

Abstract number: P-M-585

Brügger-Andersen¹ T., Aarstøy¹ H., Grundt¹ H., Mehus² M., Nilsen¹ D.W.T.

¹¹Departments of Medicine, Stavanger University Hospital ²²Departments of Clinical Chemistry, Institute of Medicine, University of Bergen, Stavanger, Norway

How-to-cite Brügger-Andersen T, Aarstøy H, Grundt H, Mehus M, Nilsen DWT. NT-PROBNP, AND NOT TF, FM, PAPP-A, MPO OR CD40 LIGAND, PREDICTS RECURRENT TROPONIN-T POSITIVE CARDIAC EVENTS FOLLOWING AN ACUTE MYOCARDIAL INFARCTION. J Thromb Haemost 2007; 5 Supplement 2: P-M-585

Abstract

Introduction: N-terminal B-type natriuretic peptide (NT-proBNP) is a marker of both left ventricular dysfunction and heart failure, and predicts mortality in patients with an acute coronary syndrome (ACS). The aim of this study was to evaluate if elevated NT-pro BNP levels are associated with increased risk of secondary troponin- T positive (TnT) coronary events during a median follow-up period of 1.5 years following an acute myocardial infarction (MI). We also wanted to evaluate the relationsship between TnT and several other proinflammatory and procoagulant markers.

Methods: We compared the recurrence of TnT positive coronary events in the upper quartile of NT-proBNP (>261,8 pmol/l) to the event rate below the 75% percentile during a median follow-up period of 1.5 years in patients with MI. Tissue factor (TF), fibrin monomer (FM), Pregnancy-associated plasma protein A (PAPP-A), myeloperoxidase (MPO) and high-sensitive C-reactive protein (hs-CRP) were also evaluated in relation to prognosis. Blood samples were drawn 4-6 days post-MI in 300 patients. Analyses of TF, FM, PAPP-A, MPO and CD40 ligand were performed by ELISA-methodology. NT-proBNP was analysed using the Abbott immunoassay.

Results: During the follow-up period 61 patients suffered an adverse TnT positive event. In the upper quartile of NT-proBNP (n=75), 33.3% had a secondary TnT positive coronary event, as compared to 16.1% in the three lower quartiles of NT-proBNP (n=224), p= 0.002. Moreover, there were no significant differences in recurrent events when comparing the upper to the lower quartiles of TF, FM, PAPP-A, MPO, and CD40 ligand.

Table:

NTpro-BNP quartiles *P=0.002 Q4 compared to Q1-Q3 for NT-proBNP	First recurrent ACS -TnT positive Values presented as number (%).
Q4 (>261,8 pmol/l)*	25 (33.3)
Q3 (>134,0-261,8 pmol/l)	10 (13.7)
Q2 (>54,0-134,0 pmol/l)	15 (20.0)
Q1 (0–54,0 pmol/l)	11 (14.5)
Q1-Q3	36 (16.1)

Conclusions: NT-proBNP predicts recurrent troponin-T positive cardiac events in survivors of a myocardial infarction.

To cite this abstract use the following format:

Journal of Thrombosis and Haemostasis 2007; Volume 5, Supplement 2: abstract number

Session Details

Date:	01/08/2007
Time:	00:00-00:00
Session name:	XXIst ISTH Congress
Subject:
Location:	Oxford, UK
Presentation type:
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