Pathophysiology, prognostic significance and clinical utility of B-type natriuretic peptide in acute coronary syndromes

Stephen D. Wiviott, James A de Lemos, David A. Morrow

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations


The natriuretic hormones are a family of vasoactive peptides that can be measured circulating in the blood. Because they serve as markers of hemodynamic stress, the major focus of the use of natriuretic peptide levels [predominantly B-type natriuretic peptide (BNP) and N-terminal (NT)-pro-BNP] has been as an aid to the clinical diagnosis and management of congestive heart failure (CHF). Recently, however, the measurement of natriuretic peptides in the acute coronary syndromes (ACS) has been shown to provide information complementary to traditional biomarkers (of necrosis) such as cardiac troponins and creatine kinase (CK). Studies in several types of acute coronary syndromes [ST-segment elevation myocardial infarction (STEMI), non-ST elevation MI (NSTEMI) and unstable angina (UA)] have shown that elevated levels of natriuretic peptides are independently associated with adverse outcomes, particularly mortality. Additional information is obtained from the use natriuretic peptides in combination with other markers of risk including biomarkers of necrosis and inflammation. This review will summarize the scientific rationale and clinical evidence supporting measurement of natriuretic peptides for risk stratification in acute coronary syndromes. Future research is needed to identify therapies of particular benefit for patients with ACS and natriuretic peptide elevation.

Original languageEnglish (US)
Pages (from-to)119-128
Number of pages10
JournalClinica Chimica Acta
Issue number2
StatePublished - Aug 16 2004


  • ANP
  • Acute coronary syndrome
  • BNP
  • Myocardial infarction
  • NT-pro-BNP
  • Natriuretic peptides
  • Review
  • Unstable angina

ASJC Scopus subject areas

  • Biochemistry
  • Clinical Biochemistry
  • Biochemistry, medical


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