The Predictive Value Of Natriuretic Peptide Precursor BNP And C-reactive Protein In The Prognosi Of Patients With Acute Coronary Syndrome (ACS)

Acute coronary syndrome (ACS) is a cardiac emergency and critical care of the circulatory system, that refers intimal injury, plaque rupture, vasospasm, then has severe stenosis, or occlusion, myocardia ischemia and hypoxia on the basis of pathology and physiology. Acute coronary syndrome is involoving in unstable angina pectoris (UAP),ST segment elevation myocardial infarction and non ST segment elevation myocardial infarction (acute myocardial infarction, AMI).The pathological process of coronary atherosclerosis is an inflammatory response, and CRP (hs-CRP) is a a non-specific markers of acute inflammation, infection, tissue damage response. Serum C-reactive protein is more sensitive indicator of inflammatory response in the current clinical, especially in patients who have acute coronary syndrome (ACS) is more sensitive.It is a sensitive, reliable indicators that can reflect coronary arteriosclerosis inflammatory state as another cardiovascular risk facto[1]. N-terminal pro-brain natriuretic peptide (NT-proBNP) and Brain natriuretic peptide (BNP) are heart failure severity and prognosis evaluation in the clinical, which mainly secreted from ventricle and its synthesis and secretion are closely related with the ventricular load and wall tension. CRP (hs-CRP), and amino-terminal pro-brain natriuretic peptide (NT-proBNP) can be timely and accurate diagnosis, treatment and prognosis. The determination of ACS patients with monitoring serum amino-terminal B-type natriuretic peptide precursor (NT proBNP) and high sensitive CRP(hs CRP) levels, in order to guide treatment and evaluate the prognosis. Described as follows.Objective:Exploring the predictive value of the level of NT-proBNP and ultra-sensitive CRP (hs-CRP), the prognosis of patients with ACS ACS patients, And joint evaluation of the program for two markers of value in risk stratification in ACS early preliminary study and analysisMethod:190ACS patients was hospitalized in the People’s Liberation Army208From August2009to August2011. Females are48cases,142cases are male, age51-75years old, average age67.23±16.2years old, in line with WHO standards of ACS diagnosis. Throuh follow-up, record the end of the event. Endpoint events included coronary heart disease (CHD) death, myocardial infarction (MI), heart failure (HF). Results:Through the calculation of the SPSS software, according to the ROC curve, combine sensitivity and specificity in mapping methods. The ROC curve is not fixed classification boundary value, select a better cut-off point as a diagnostic reference values. According to ROC curve analysis results, it indicated that serum markers to determine the composite outcome efficiency, the best cutoff value (cutoff value) were that NT-proBNP is614.3ng/L and hs-CRP is10mg/L. ACS were divided into low group and high-value group to observe each group incident,according to the cutoff values of each marker to judge events in patients. In the follow-up one month, six months, high-value group of two markers of coronary heart disease relative risk of death (CHD) were significantly increased, compared with the low group. In a high-value group of the two markers of MI risk is a significant increasing in one month. In the six months, the incidence of MI risk in cThT high-value group is no significant difference. Endpoint HF, Hs-CRP value group is only dangerous when in the follow-up of a significant increase in risk, high-value group of NT-proBNP in the follow-up time significantly increased. This risk is more prominent in the high value of NT-proBNP group. BNP and CRP levels in MACE patients with ACS group were significantly increased than the non-MACE patients with ACS group.Conclusions:1. Hs-CRP as an inflammatory protein factor and its level in patients with ACS short-term including short and long term MACE has good predictive value, and of great value in the ACS risk stratification.2. NT-proBNP level can be used as indicators of the severity of coronary artery disease predict acute myocardial ischemia,coronary artery disease risk stratification of great significance, while closely related to the ACS patients and long-term cardiovascular events.3. Hs-CRP and NT-proBNP have predictive value of MACE in ACS patients with early and future.