BNP was Associated with Ischemic Myocardial Scintigraphy and Death in Patients at Chest Pain Unit

Background

Recent studies have suggested that B-type Natriuretic Peptide (BNP) is animportant predictor of ischemia and death in patients with suspected acutecoronary syndrome. Increased levels of BNP are seen after episodes of myocardialischemia and may be related to future adverse events.

Objectives

To determine the prognostic value of BNP for major cardiac events and to evaluateits association with ischemic myocardial perfusion scintigraphy (MPS).

Methods

This study included retrospectively 125 patients admitted to the chest pain unitbetween 2002 and 2006, who had their BNP levels measured on admission andunderwent CPM for risk stratification. BNP values were compared with the resultsof the MPS. The chi-square test was used for qualitative variables and the Studentt test, for quantitative variables. Survival curves were adjusted using theKaplan-Meier method and analyzed by using Cox regression. The significance levelwas 5%.

Results

The mean age was 63.9 ± 13.8 years, and the male sex represented 51.2% ofthe sample. Ischemia was found in 44% of the MPS. The mean BNP level was higher inpatients with ischemia compared to patients with non-ischemic MPS (188.3 ±208.7 versus 131.8 ± 88.6; p = 0.003). A BNP level greater than 80 pg/mLwas the strongest predictor of ischemia on MPS (sensitivity = 60%, specificity =70%, accuracy = 66%, PPV = 61%, NPV = 70%), and could predict medium-termmortality (RR = 7.29, 95% CI: 0.90-58.6; p = 0.045) independently of the presenceof ischemia.

Conclusions

BNP levels are associated with ischemic MPS findings and adverse prognosis inpatients presenting with acute chest pain to the emergency room, thus, providingimportant prognostic information for an unfavorable clinical outcome.