Format

Send to

Choose Destination
Int J Cardiol. 2017 Apr 1;232:264-270. doi: 10.1016/j.ijcard.2017.01.007. Epub 2017 Jan 4.

Fasting glucose, NT-proBNP, treatment with eptifibatide, and outcomes in non-ST-segment elevation acute coronary syndromes: An analysis from EARLY ACS.

Author information

1
3rd Department of Internal Medicine, Cardiology, and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria.
2
Duke Clinical Research Institute, Durham, NC, USA.
3
TIMI Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
4
Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA.
5
3rd Department of Internal Medicine, Cardiology, and Intensive Care Medicine, Wilhelminen Hospital, Vienna, Austria. Electronic address: kurt.huber@meduniwien.ac.at.

Abstract

BACKGROUND:

Higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been linked to a more favorable glucometabolic profile. Little is known about the interaction of NT-proBNP and fasting glucose in non-ST-segment elevation acute coronary syndrome (NSTE ACS).

METHODS:

Fasting glucose and NT-proBNP were measured in 2240 patients enrolled in the EARLY ACS trial. Multivariable Cox models were used to assess associations between fasting glucose and NT-proBNP and a 96-hour composite of death, myocardial infarction (MI), recurrent ischemia, or thrombotic bailout; 30-day death or MI; and 1-year mortality.

RESULTS:

In adjusted Cox models, neither NT-proBNP nor fasting glucose was associated with the 96-hour endpoint (p=0.95 and p=0.87). NT-proBNP was associated with 30-day death or MI (hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.02-1.22, p=0.02) and 1-year mortality (HR 1.63, 95% CI 1.42-1.89, p<0.0001), but fasting glucose was associated only with 1-year death (HR 1.53, 95% CI 1.08-2.16, p=0.02). NT-proBNP×glucose interaction terms were non-significant in all models. As fasting glucose levels increased, the risk of 96-hour and 30-day endpoints increased among patients who received early eptifibatide but not delayed, provisional use (pint=0.035 and pint=0.029). Higher NT-proBNP levels were associated with greater 30-day death or MI among patients who received early eptifibatide but not delayed, provisional use (pint=0.045).

CONCLUSION:

NT-proBNP and fasting glucose concentrations were associated with intermediate-term ischemic outcomes and may identify differential response to treatment with eptifibatide. CLINICALTRIALS.

GOV IDENTIFIER:

NCT00089895.

KEYWORDS:

Acute coronary syndrome; Eptifibatide; Fasting glucose; Glycoprotein IIb/IIIa inhibitor; NT-proBNP

PMID:
28089149
DOI:
10.1016/j.ijcard.2017.01.007
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center