High sensitivity C-reactive protein, NT-proBNP and hemodynamic left ventricular function in acute coronary syndrome
Grzegorz Piotrowski1, Rafał Gawor, Maciej Banach
1Department of Cardiology, M. Kopernik Specialist District Hospital, Lodz, Poland. gpiotr4@wp.pl
Insights
This study compared cardiac markers and heart function in acute coronary syndromes (ACS). No direct correlation was found between hsCRP, Nt-proBNP, and echocardiographic measures in unstable angina or NSTEMI patients.
Area of Science:
- Cardiology
- Biomarkers
- Echocardiography
Background:
- Prognostic factors in acute coronary syndromes (ACS) are crucial for patient management.
- This study investigates shifts in humoral markers and left ventricular systolic function in early ACS.
Purpose of the Study:
- To compare changes in high-sensitivity C-reactive protein (hsCRP) and N-terminal pro-B-type natriuretic peptide (Nt-proBNP) concentrations with hemodynamic left ventricular systolic function indices in ACS patients.
Main Methods:
- The study included 33 patients with ACS without ST segment elevation, divided into unstable angina (uAP) and myocardial infarction without ST segment elevation (NSTEMI) groups.
- Blood samples for hsCRP and Nt-proBNP were collected 6-12 hours post-admission.
- Echocardiography was performed on days 2-3 to assess left ventricular function.
Main Results:
- A positive correlation between hsCRP and Nt-proBNP was observed in the uAP group (Group I).
- No such correlation was found in the NSTEMI group (Group II).
- No correlation was identified between humoral markers (hsCRP, Nt-proBNP) and hemodynamic parameters in either group.
Conclusions:
- Complex evaluation of post-ACS prognosis requires a multifaceted approach.
- Integrating hemodynamic assessment via echocardiography with humoral risk markers is recommended for comprehensive patient evaluation.
Background:
Prognostic factors in acute coronary syndromes have been the subject of interest in cardiology over the last few years. Our study aimed to compare humoral marker concentration shifts (hsCRP, Nt-proBNP) and hemodynamic left ventricular systolic function index changes, determined by means of echocardiography in the first hours of acute coronary syndromes (ACS).
Material/Methods:
The study comprised 33 patients with ACS without ST segment elevation. Group I consisted of 18 patients (11 men, 7 women aged from 48 to 77, mean age 67+/-35 years) with unstable angina pectoris (uAP). Group II consisted of 15 patients (10 men, 5 women aged from 51 to 80, mean age 70+/-11.9 years) with myocardial infarction without ST segment elevation (NSTEMI). In all patients, Nt-proBNP and hsCRP blood concentrations were determined between the 6th and 12th hours after admission to the intensive coronary care unit. On the 2nd-3rd day, after coronary stabilization, routine echocardiography was performed in each patient to assess left ventricular function.
Results:
A positive correlation between hsCRP and Nt-proBNP in uAP was observed in group I. In group II, in patients with NSTEMI no such correlation was observed. There was also no correlation in either study group between humoral (hsCRP and Nt-proBNP) and hemodynamic parameters.
Conclusions:
The complex evaluation of the post-ACS prognosis should be multifaceted. It should contain hemodynamic assessment of the left ventricle by means of echocardiography as well as humoral coronary risk markers.
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