Copyright © 2004 by the European Society of Cardiology.
Review
Natriuretic peptides in unstable coronary artery disease
a Department of Medical Sciences, Cardiology and Uppsala Research Center, Sweden
b Department of Medical Sciences, Clinical Chemistry, Sweden
Received March 1, 2004; revised June 5, 2004; accepted June 10, 2004 * Corresponding author. Tel: +46-18-611-0232; fax: +46-18-50-66-38 (E-mail: tomas.jernberg{at}medsci.uu.se).
Patients with unstable coronary artery disease (CAD), i.e., unstable angina or non-ST-elevation myocardial infarction, vary widely in clinical presentation, prognosis and response to treatment. To select appropriate therapy, early risk stratification has become increasingly important. This review focuses on the emerging role of natriuretic peptides in the early assessment of patients with unstable CAD. We conclude that levels of brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are strongly associated to mortality and the risk of future congestive heart failure, and carry important prognostic information independent from previously known risk factors in unstable CAD. There are some data indicating that these markers can also be helpful in the selection of appropriate therapy in these patients but further studies are needed. Before a routine use of BNP or NT-proBNP in unstable CAD can be recommended, the cost-effectiveness of adding these new markers to the currently routine markers and their impact on selection of treatment needs further evaluation.
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