Prognostic value of levels of brain natriuretic peptide and genetic factors in patients after acute coronary syndrome

Prognostication of the course of disease in patients with high risk of unfavorable outcome of ischemic heart disease (IHD) is of great importance for creation of individualized strategy of treatment. We have investigated contribution of levels of brain natriuretic peptide (BNP) and genetic factors i...

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Published inKardiologiia Vol. 51; no. 2; p. 26
Main Authors Evdokimova, M A, Aseĭcheva, O Iu, Baklanova, T N, Chumakova, O S, Panfilova, E Iu, Reznichenko, N E, Brovkin, A N, Nikitin, A G, Agapkina, Iu V, Osmolovskaia, V S, Kockina, M Iu, Selezneva, N D, Zateĭshchikova, A A, Talyzin, P A, Sidorenko, B A, Nosikov, V V, Zateĭshchikov, D A
Format Journal Article
LanguageRussian
Published Russia (Federation) 2011
Subjects
Acute Coronary Syndrome - blood
Acute Coronary Syndrome - diagnosis
Acute Coronary Syndrome - genetics
Alleles
Coronary Angiography
DNA - genetics
Electrocardiography
Female
Follow-Up Studies
Humans
Immunoenzyme Techniques
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Polymerase Chain Reaction
Polymorphism, Genetic
Prognosis
Protein C - genetics
Protein C - metabolism
Time Factors
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Summary:Prognostication of the course of disease in patients with high risk of unfavorable outcome of ischemic heart disease (IHD) is of great importance for creation of individualized strategy of treatment. We have investigated contribution of levels of brain natriuretic peptide (BNP) and genetic factors in the risk of development of complications of atherosclerosis in patients who have had acute coronary syndrome. We started to follow 324 patients on day 10 of stable state after acute coronary syndrome (55.1% with Q-wave myocardial infarction, 18.5% with non-Q myocardial infarction, 25.5% with unstable angina, men BNP level 624.5+/-32.13 mol/ml [70.3 - 4276.6]). Duration of followup was 2 years. Baseline BNP level in patients with unfavorable outcome during followup (fatal and nonfatal myocardial infarction and stroke) was 872.47+/-91.42 compared with 592.45+/-35.97 mol/ml in patients without unfavorable outcome (p=0,001). Multifactorial Cox analysis showed that carriage of T allele of polymorphic marker (--1654) of protein C gene, elevated BNP level, symptomatic atherosclerosis of peripheral arteries, history of MI, and use of thiazide diuretics were independently associated with unfavorable outcomes (p=0.026, <0.0001, <0.0001, =0.001, =0.024, respectively). Thus genetic factors and study of BNP allow to improve prediction of unfavorable outcome after exacerbation of IHD.
ISSN:0022-9040