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Coron Artery Dis. 2013 Jan;24(1):33-9. doi: 10.1097/MCA.0b013e32835b6741.

Natriuretic peptides in acute chest pain and acute coronary syndrome: from pathophysiology to clinical and prognostic applications.

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Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy.



Plasma levels of natriuretic peptides (NPs) appear to have an important prognostic value in many clinical settings including coronary artery disease and provide additional information about cardiovascular risk.


The aim of this study was to review the literature on the role of NPs in the prognosis and management of patients with acute chest pain and acute coronary syndrome (ACS). Several trials have assessed the prognostic value of NPs as biomarkers of myocardial injury for risk stratification in patients with acute chest pain and ACS. The additional prognostic information on measurement of NP levels is independent of that provided by cardiac troponin and the various clinical and ECG features and traditional risk markers available at hospital admission.


Although measurement of the level of NPs is not recommended as a diagnostic tool in ACS management, their concentrations seem to distinguish patients at a higher risk not only for heart failure but also for ACS. NPs are a good risk marker for ACS, in addition to troponins, but have not yet been proved suitable for guiding therapy.

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