Study On Correlation Between NT-proBNP, CK-MB, Hs-CRP And GRACE Score In Patient With Acute Coronary

Objective: to study the correlation between NT-proBNP, CK-MB, hs-CRP and GRACE score and further discuss its possible mechanism.Methods:there were156patients with acute coronary in this study, including79cases of ST-segment elevation MI (STEMI),47non-ST-segment elevation MI (NSTEMI) and30unstable angina pectoris (UAP).31patients with coronary angiography (CAG) in the same period were selected as a negative control. Levels of NT-proBNP, CK-MB and hs-CRP in peripheral blood of patients in each group were measured by radioimmunoassay in the next morning after be admitted to hospital. All patients were scored using GRACE score tool and risk Stratification was carrying out according to their scores. Low risk: GRACE score<108, the risk of death in Branch within<1%; middle risk:GRACE score is between109and140, the risk of death in Branch is between1%and3%; high risk: GRACE score>140, the risk of death in Branch within>3%.Results:Levels of NT-proBNP, hs-CRP and CK-MB in ACS syndrome group were higher tnan those in control group. There is a positive correlation between GRACE score and serum NT-proBNP, hs-CRP and CK-MB. The higher serum BNP, hs-CRP and CK-MB levels are, the more severe their degree of coronary artery disease.Spearman correlation coefficients display that serum NT-proBNP and CK-MB in ACS group were positively correlated (r=0.63and0.21) and significantly higher than that in control group (P<0.05). There was no significant correlation between hs-CRP and NT-proBNP, CK-MB. Simultaneous elevation of NT-proBNP and CK-MB was related with early mechanical complications such as cardiac rupture, aneurysm and thrombosis. Elevated CRP did not predict risk of reinfarction.Levels of NT-proBNP, hs-CRP and CK-MB were simultaneously elevated, the higher the elevated value is, the higher GRACE risk stratification score is. The first two elevated better correlation with the GRACE score.Discussion:Levels of NT-proBNP, hs-CRP and CK-MB in ACS syndrome group were higher tnan those in control group. The higher the elevated value is, the higher GRACE risk stratification score is. STEMI accounted for1/2, NSTEMI accounted for1/4, and UAP accounted for1/4in high-risk group. Levels of NT-proBNP, hs-CRP and CK-MB were significantly decreased in low and middle-risk groups.NT-proBNP, hs-CRP were positively correlated with the GRACE score, the correlation of CK-MB is weak in NSTEMI.For prediction of cardiac events in patients with ACS and for clinical prognosis, multiple biochemical markers were more accurate and specific than a single biochemical marker.Independent of the other indicators, NT-proBNP is predicted to play early risk indicators in clinical ACS patients as compared with the GRACE score.