Clinical correlation of multiple biomarkers for risk assessment in patients with acute coronary syndrome.

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dc.contributor.authorNarain, V Sen_US
dc.contributor.authorGupta, Nishanten_US
dc.contributor.authorSethi, Rishien_US
dc.contributor.authorPuri, Aniketen_US
dc.contributor.authorDwivedi, S Ken_US
dc.contributor.authorSaran, R Ken_US
dc.contributor.authorPuri, V Ken_US
dc.date.accessioned2008-11-12en_US
dc.date.accessioned2009-05-27T04:19:52Z
dc.date.available2008-11-12en_US
dc.date.available2009-05-27T04:19:52Z
dc.date.issued2008-11-12en_US
dc.description.abstractOBJECTIVE: Biochemical markers are useful for the prediction of future cardiovascular events in patients with non-ST-segment elevation acute coronary syndrome (ACS). The independent as well as the combined prognostic value of elevated troponin-T, high-sensitivity C-reactive protein (hs-CRP), and N-terminal pro-brain natriuretic peptide (NT-pro-BNP) on the Thrombolysis In Myocardial Infarction (TIMI) risk score and on the short-term prognosis were evaluated in a cohort of ACS patients. METHODS AND RESULTS: In an unselected, heterogeneous group of 80 patients with ACS (i.e., unstable angina [USA] or non-ST-elevation myocardial infarction [NSTEMI]), the levels of troponin-T, hs-CRP, and NT-pro-BNP were analyzed. The correlation between elevation of different biomarkers with TIMI risk score and their impact on 30-day major adverse cardiac events was sought. The levels of hs-CRP were significantly higher in patients who had angina as their predominant complaint (3.67 mg/dl vs. 1.67 mg/dl: p < 0.01), while levels of NT-pro-BNP was higher in those patients who had any element of heart failure at presentation (2616.39 pg/ml vs. 1068.3 pg/ml; p < 0.01). Troponin-T was highest in patients who had an element of both heart failure and angina at presentation (p < 0.01). The TIMI risk score expectedly had a positive and strong correlation with elevated troponin-T, but had no correlation with elevation of hs-CRP and NT-pro-BNP in isolation. However, when any two biomarkers were elevated, the patients were in the intermediate risk group as per TIMI risk score irrespective of troponin-T-elevation. When all the three biomarkers were elevated, the risk equaled the high-risk category of TIMI risk score. Elevated hs-CRP (3.40 mg/dl vs. 1.38 mg/dl; p < 0.001) and troponin-T (2.37 ng/ml vs. 1.23 ng/ml; p < 0.001) at baseline correlated independently with the occurrence of re-ischemia, while elevated NT-pro-BNP alone correlated significantly with the development of heart failure within 30 days of follow-up (4247.76 pg/ml vs. 1210.86 pg/ml; p < 0.01). The highest risk of death from any cardiovascular cause within 30 days of follow-up was significantly higher when all the three biomarkers were elevated. CONCLUSION: The use of NT-pro-BNP, hs-CRP, and troponin-T in combination appears to add critical prognostic insight to the assessment of patients with ACS.en_US
dc.description.affiliationDepartment of Cardiology, King George Medical University, Lucknow.en_US
dc.identifier.citationNarain VS, Gupta N, Sethi R, Puri A, Dwivedi SK, Saran RK, Puri VK. Clinical correlation of multiple biomarkers for risk assessment in patients with acute coronary syndrome. Indian Heart Journal. 2008 Nov-Dec; 60(6): 536-42en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/3587
dc.language.isoengen_US
dc.source.urihttps://indianheartjournal.comen_US
dc.subject.meshAcute Coronary Syndrome --diagnosisen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshC-Reactive Protein --analysisen_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshIndiaen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshNatriuretic Peptide, Brain --analysisen_US
dc.subject.meshPeptide Fragments --analysisen_US
dc.subject.meshPrognosisen_US
dc.subject.meshRisk Assessment --methodsen_US
dc.subject.meshStatistics as Topicen_US
dc.subject.meshTroponin T --analysisen_US
dc.titleClinical correlation of multiple biomarkers for risk assessment in patients with acute coronary syndrome.en_US
dc.typeJournal Articleen_US
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