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Valor pronóstico del péptido natriurético proencefálico N-terminal en pacientes con angina crónica estable
Gjin Ndrepepa1, Siegmund Braun, Kathrin Niemöller
1Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Germany.
Circulation
|September 28, 2005
Resumen
Los niveles de péptido natriurético proencefálico N-terminal (NT-proBNP) son un fuerte marcador pronóstico para los pacientes con angina crónica estable. Los niveles más altos de NT-proBNP se correlacionan significativamente con un mayor riesgo de mortalidad en estos pacientes.
Área de la Ciencia:
- Cardiología Cardiología.
- Investigación de biomarcadores Investigación de biomarcadores.
- El pronóstico clínico.
Sus antecedentes:
- La angina crónica estable carece de biomarcadores pronósticos bien definidos.
- La evaluación del pronóstico es crucial para guiar las decisiones de tratamiento en pacientes con angina de pecho.
Objetivo del estudio:
- Para investigar el péptido natriurético pro-cerebral N-terminal (NT-proBNP) como un marcador de pronóstico.
- Evaluar el NT-proBNP en pacientes con angina crónica estable sometidos a stenting coronario.
Principales métodos:
- Se midieron los niveles plasmáticos de NT-proBNP en 1059 pacientes con angina estable.
- La angiografía coronaria confirmó una enfermedad arterial coronaria significativa.
- Se siguió a los pacientes para la mortalidad (punto final primario) durante una mediana de 3,6 años.
Principales resultados:
- Los niveles elevados de NT-proBNP se correlacionaron fuertemente con un aumento de la mortalidad por todas las causas.
- El análisis de Kaplan-Meier mostró una mortalidad a 5 años significativamente mayor con un aumento de los cuartiles NT-proBNP (P<0,001).
- NT-proBNP fue el predictor más fuerte de mortalidad (aHR, 5.83 para el cuartil más alto vs. más bajo).
Conclusiones:
- Los niveles circulantes de NT-proBNP sirven como un potente biomarcador pronóstico.
- NT-proBNP predice efectivamente la mortalidad, incluida la mortalidad cardiovascular, en pacientes con angina estable.
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