Evaluation Of BNP,hs-cTn T,GDF-15,copeptin,PTX-3 With GRACE Score In Eldly Patients With Non-ST-elevation Acute Coronary Syndrome And Normal Left Ventricular Systolic Function At 1 Year

Objective: To explore the prognostic valve of BNP,hs-c Tn T,GDF-15,Copeptin,PTX-3 with GRACE risk score in eldly patients with non-ST-elevation acute coronary syndrome(NSTACS) and normal left ventricular systolic function at 1 year.Methods: 204 patients age≥75, with NSTACS and normal left ventricular systolic function without raised c Tn T, were enrolled and divided into invasive group and conservative group.The invasive patients were underwent coronary angiography within 48 hour after admission.BNP,hs-c Tn T,GDF-15,Copeptin,PTX-3 were measured in all patiens.We evaluated the prognosis of BNP,hs-c Tn T,GDF-15,Copeptin,PTX-3 and GRACE risk score with non fatal myocardial infarction and cardiovascular death at 1 year.Results: The level of BNP,hs-c Tn T,GDF-15,Copeptin,PTX-3, related with Gensini score,rose significantly with increasing number of vessel involved and severity of coronary artery.The patients with high BNP,hs-c Tn T,GDF-15,Copeptin,PTX-3 with short survival time,had high risk of non fatal myocardial infarction and cardiovascular death at 1 year.Adjustment of the GRACE risk estimate by BNP,hs-c Tn T,GDF-15,Copeptin,PTX-3,increased the area under the receive-operating characteristic curve(AUC).Discrimination improvement was confirmed by an integrated discrimination improvement(IDI) and net reclassification improvement(NRI).Difference was observerd in the effective of invasive verus conservative management in high level of hs-c Tn T,GDF-15,PTX-3,but no difference in high level of BNP and Copeptin.Conclusions: High level of BNP,hs-c Tn T,GDF-15,Copeptin,PTX-3,associated with multi-vessel disease and diffuse aoronary artheroscerosis, had incremental prognostic valve with GRACE risk score in the eldly patients with non-ST-elevation acute coronary syndrome and normal left ventricular systolic function.Additional works are needed to identify therapies that may reduce the risk associated with incureased BNP and Copeptin.