Prognostic and Diagnostic Value of ProBNP in Iranian Patients With Chest Pain at a Tertiary Cardiovascular Center

Diagnosis and early treatment of the cardiac causes of chest pain are of particular importance. This study aimed to investigate the association between NT-pro-BNP levels as a cardiac marker and the prognosis of patients with chest pain.

All patients visiting the emergency department of a tertiary cardiovascular center with chest pain between October 2016 and March 2017 were evaluated for eligibility. Demographic data, proBNP levels, final diagnosis on angiography, echocardiography, and other symptoms were recorded.

A total of 222 patients at a mean age of 59.0±14.8 years were studied. Totally, 127 patients (57.2%) were male. A significant inverse relationship was found between proBNP levels and the left ventricular ejection fraction (r= -0.316; P<0.001). NT-proBNP levels showed a significant elevation in patients with abnormal size and function of the right ventricle, with regional wall motion abnormalities, and with valvular heart diseases (P<0.05). The BNP level in patients with abnormal angiographic results was 1148.5 (405.3–3214.0), significantly higher than that in patients with normal results (545.0: 90.3–2807.8; P=0.009). The level of this marker in patients with obstructive coronary artery disease (1192.0: 438.8–3233.0) was significantly higher than that in patients with non-obstructive coronary artery disease (620.0: 108.0–2792.0; P=0.001). BNP>841 pg/mL had a sensitivity of 92.9% and a specificity of 47.9% in identifying cases at risk of complications.

NT-proBNP could be a good diagnostic and prognostic marker for patients with chest pain complaints. Measuring this marker upon arrival can help identify patients with cardiac diseases. It is recommended to evaluate patients with elevated levels of this marker for earlier diagnosis and treatment.