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Natriuretic peptide in acute coronary syndrome associated with chronic kidney disease

Shalenkova M. A., Mikhaylova Z. D., Manyukova E. T., Klimkin P. F.

Keywords: acute coronary syndrome, chronic kidney disease

DOI: 10.18087/rhj.2014.2.1914

Background. Natriuretic peptides (BNP, NT-proBNP) are independent predictive factors for CHF, MI and death in acute coronary syndrome (ACS). NT-proBNP levels may be also increased in chronic kidney disease (CKD). Aim. To evaluate the significance of NTproBNP level in ACS associated with pre-dialysis CKD. Materials and methods. 153 patients with ACS were evaluated. 64 patients had unstable angina (UA); 89 patients had MI. Blood levels of NT-proBNP and creatinine were measured in all patients on days 1–3 of hospitalization. Glomerular filtration rate (GFR) was calculated using the MDRD and CKD-EPI equations. Results. A greater proportion of ACS patients had stage 2 CKD independent on their age, gender, ACS type, and cardiovascular complications. Median (Ме) NT-proBNP linearly increased at more advanced CKD stages from 203 [71; 355] in MI patients with stage 1 CKD to 8310 [769; 13510] in MI patients with stage 4 CKD. NT-proBNP levels significantly inversely correlated with GFR values in patients with MI (R= –0.326, p=0.003) and UA (R= –0.352, p=0.007). Conclusion. A greater proportion of patients with ACS had mild impairment of renal function (stage 2 CKD in 53 %). NT-proBNP levels correlated with CKD severity.
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