Prognostic Value of B-Type Natriuretic Peptide in Unstable Coronary Artery Disease

摘要

To the Editor: Dr Morrow and colleagues1 studied the prognostic value of serial testing of B-type natriuretic peptide (BNP) in patients with unstable coronary artery disease. I am not certain of the validity of their conclusion that changes in BNP levels are associated with long-term clinical outcomes and may provide enhanced decision making in these patients.A crucial issue is whether BNP measurement provides important incremental prognostic information beyond that available to a clinician from a patient interview, such as an assessment of health status (symptoms, functional status, and quality of life). Level of BNP could be little more than a costly surrogate measure of health status that merely identifies those with a greater burden of heart disease. This cannot be determined from this article because the results were not adjusted for health status