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N-terminal pro-brain natriuretic peptide in relation to inflammation, myocardial necrosis, and the effect of an invasive strategy in unstable coronary artery disease

Tomas Jernberg, MD, PhD^*,*, Bertil Lindahl, MD, PhD^*, Agneta Siegbahn, MD, PhD, Bertil Andren, MD, PhD, Gunnar Frostfeldt, MD, PhD^*, Bo Lagerqvist, MD, PhD^*, Mats Stridsberg, MD, PhD, Per Venge, MD, PhD and Lars Wallentin, MD, PhD^*

^* Department of Medical Sciences, Cardiology, Cardiothoracic Center, University Hospital, Uppsala, Sweden
Department of Medical Sciences, Clinical Chemistry, Cardiothoracic Center, University Hospital, Uppsala, Sweden
Department of Medical Sciences, Clinical Physiology, Cardiothoracic Center, University Hospital, Uppsala, Sweden
Uppsala Clinical Research Institute, University Hospital, Uppsala, Sweden

View larger version (26K): [in a new window]   Figure 1 Cumulative probability of death in relation to the level of N-terminal pro-brain natriuretic peptide (NT-proBNP) and treatment strategy in (A) all patients, (B) patients with interleukin-6 (IL-6) <5 ng/l, and (C) patients with IL-6 5 ng/l. 1) First or second tertile of NT-proBNP plus non-invasive strategy; 2) first or second tertile of NT-proBNP plus invasive strategy; 3) third tertile of NT-proBNP plus non-invasive strategy; 4) third tertile of NT-proBNP plus invasive strategy—whole group: n = 655, 691, 353, and 320; IL-6 <5 ng/l group: n = 520, 540, 190, and 187; IL-6 5 ng/l group: n = 122, 140, 156, and 129, respectively.

View larger version (34K): [in a new window]   Figure 2 Risk of myocardial infarction in relation to the level of N-terminal pro-brain natriuretic peptide (NT-proBNP), cardiac troponin T (cTnT), and treatment strategy. Open columns = non-invasive strategy; solid columns = invasive strategy.

View larger version (30K): [in a new window]   Figure 3 Two-year mortality in relation to level of N-terminal pro-brain natriuretic peptide (NT-proBNP), graded left ventricular ejection fraction (LVEF), and treatment strategy. Open columns = first or second tertile of NT-proBNP; solid columns = third tertile of NT-proBNP.