A Systematic Review Of B-type Natriuretic Peptide On Acute Coronary Syndromes

Background: Acute coronary syndrome(ACS)is an emergency of coronary heart disease,including unstable angina pectoris,non-ST segment elevation myocardial infarction and ST-segment elevation myocardial infarction.The synthesis and secretion of brain natriuretic peptide(BNP)is mainly caused by the regulation of ventricular wall tension caused by ventricular volume and/or pressure overload.The status of BNP in the diagnosis,assessment,prognosis and treatment of heart failure has been established.Recently a large number of clinical studies found that patients with plasma BNP concentration was significantly higher than the normal level.Objective: The aim of this study was to investigate the diagnostic value of BNP and the severity of coronary artery disease.Methods: A literature search was performed from 6 main databases.We used the terms: brain natriuretic peptide,B-type Natriuretic Peptide(BNP),N-terminal brain natriuretic peptide(NT-proBNP),acute coronary syndrome(ACS),Unstable angina(UA),Non-ST-segment elevation myocardial infarction(NSTEMI),ST-segment elevation myocardial infarction(STEMI).31 studies were included in our study.The meth-odological quality of non-RCTs was assessed with the Newcastle–Ottawa Scale.Forest plots were produced by using Revman 5.3 software.Results: The plasma BNP level of patients with ACS,AMI and UA was higher than that of the normal control group.Plasma BNP level of NSTEMI patients was higher than UA patients.STEMI patients was higher than that of NSTEMI patients.Meanwhile,the plasma BNP levels in double-vessel disease group were higher in ACS patients than in one-vessel disease groups.The three-vessel disease patients had higher plasma BNP levels than double-vessel disease.Conclusions: With the aggravation of coronary artery lesion,the BNP value of patients with acute coronary syndrome also increases.Well-designed multicentric RCTs with long-term follow-up are still needed.