Objective To study the relationship between NT-proBNP levels obtained on admission and GRACE risk score as well as risk stratification in patients with NSTEACS (UA/NSTEMI).
Methods We enrolled 126 patients with unstable angina or Non-ST-segment elevation myocardial infarction that admitted in our hospital from June of 2009 to May of 2010, 84 of the patients with UA and 42 of them with NSTEMI. Then measured their concentration of plasma NT-proBNP, cTnI, CK-MB, liver and kidney function, blood coagulation function and other Routine laboratory tests on admission. All the patients received echocardiography evaluation and 124 of them underwent angiographic examination. All the patients received risk assessment based on Clinical data, the Global Registry of Acute Coronary Events (GRACE) score which include 8 variables (age, heart rate, systolic blood pressure, serum creatinine level, Killip class at admission, presence of ST-depression, elevated cardiac biomarkers, cardiac arrest)were used to evaluate Clinical Risk. After calculate the GRACE score, the patients were stratified into three levels. Analyse the relationship between NT-proBNP level and GRACE risk score in patients with NSTEACS.
Results The lgNT-ProBNP in patients with UA and NSTEMI have positive correlation with their GRACE risk score, correlation coefficients were 0.40 and 0.52, respectively (p<0.05); the correlation coefficient of NT-proBNP level and GRACE risk score for all the patients (n=126) was 0.59 (p<0.05). After GRACE risk stratification, lgNT-ProBNP of high-risk group was the highest among the three groups (p<0.05), however, the difference of GRACE score between middle-risk group and low-risk group had no statistical significance (p>0.05). The lgNT-ProBNP in high-risk group was higher than non- high-risk group.
Conclusion Increased NT-proBNP level was associated with increased GRACE score in NSTEACS patients; NT-proBNP level of high-risk group increased significantly and was higher than non- high-risk group. NT-proBNP level in patients with NSTEACS was related to clinic risk and valuable for risk stratification in patients with NSTEACS.