To Explore The Value Of Plasma NT-proBNP And Hypersensitive C-reactive Protein In Evaluating The Prognosis Of The Patients With Acute Coronary Syndrome

Objective: To study the level differences of Plasma NT-ProBNP, Hs-CRP and Other blood indicators and the relationship between them and Cardiac structure,function in the Patients with Acute Coronary Syndrome, further explore the value in evaluating the prognosis of the patients with Acute Coronary Syndrome.Methods: All cases were inpatients during May of 2009 to October of 2010 ACS patients from affiliated Shanghai East Hospital of Tongji university, 61 males cases and 37 females cases,age is between 38 and 80-year-old .The patients with ACS were divided into three groups: 33 cases of UA, 32 cases of NSTEMI and 33 cases of STEMI. Collected patients, serum NT-proBNP, Hs-CRP, as well as Cr, BUN, UA etc. Indicators were tested by the laboratory of Shanghai East Hospital. All cases were checked by iE33 Doppler echocardiography of Philips. The following indicators were recorded: Structural parameters ( LAD, LVEDd, LVEDs, IVST, LVPWd); Cardiac function parameters(SV, FS, CO, LVEF).Applied the SPSS 17.0 statistical soft ware for statistical analysis. Kruska-Wallis rank sum test was used for analysis the differences in echocardiographic indicators of each group; log-transformed NT-proBNP,Hs-CRP, t-test was applied for analysis the differences in blood indicators of each group; Spearman rank correlation test was used for analysis the correlation between blood indicators and echocardiographic indicators; multiple stepwise regression analysis was applied for analysis the multi-factor correlation analysis between blood parameters and echocardiographic indicators, and the introduction variable was set to the standard of 0.05, the excluding test variable was set to the standard of 0.1.Results: (1)Plasma NT-proBNP,Hs-CRP levels in MI group (including NSTEMI group and STEMI group) was significantly higher than the UA group(P<0.05),and differences in the NSTEMI group and STEMI group was no significant(P>0.05). (2)The SV,FS,CO,LVEF levels in NSTEMI group was obviously lower than the UA group(P<0.05), The FS,LVEF levels in STEMI group was significantly lower than the UA group(P<0.05), the LVPWd levels in STEMI group was obviously higher than the UA group(P<0.05), there was no significant differences in STEMI group and NSTEMI group. (3) Plasma NT-proBNP levels was negatively correlated with SV,FS,CO,LVEF(P<0.05),and positively correlated with LAD,LVEDs; Plasma Hs-CRP levels was negatively correlated with FS,LVEF (P<0.05).Conclusions:(1) Plasma NT-proBNP,Hs-CRP levels can be used as the index for prompting the severity of ACS patients.(2) Plasma NT-proBNP was positively correlated with Hs-CRP in the patients with Acute Coronary Syndrome, there may be a unique synergy between NT-proBNP and inflammatory cytokines.(3) The detection of NT-proBNP, Hs-CRP levels, was not only a sensitive indicator for evaluation of the extent of damage of cardiac function in patients with ACS, may be a useful index for determine of the myocardial ischemia, necrosis, inflammatory reaction. Levels of NT-proBNP,Hs-CRP may play an important role in evaluating the decrease of early cardiac function of Acute Coronary Syndrome and the prognosis of ACS patients.