B-type natriuretic peptides: prognostic markers in stable coronary artery disease

摘要

Circulating concentrations of B-type natriuretic peptide (BNP) and the N-terminal fragmentn(NT) of its prohormone (proBNP) are related to cardiac function and have emerged as clinicallynuseful tools for the diagnosis of heart failure and for the estimation of prognosis in patientsnwith heart failure and acute coronary syndromes. Recent studies have also convincinglyndocumented that both BNP and NT-proBNP are powerful, independent prognostic indicators innpatients with stable coronary artery disease. The associations are strongest for the end-pointsnof death and heart failure, whereas the association with cardiac ischemic events is weaker ornnonexistent, after adjustment for confounding factors. Importantly, BNP and NT-proBNPnappear to provide incremental prognostic information to conventional risk factors, includingnmarkers of ventricular function and ischemia. Data documenting that BNP or NT-proBNPnmeasurements can be used to guide treatment decisions in patients with stable coronarynartery disease are still lacking.