Trial reportJournal of the American College of Cardiology2003
Evaluation of B-type natriuretic peptide for risk assessment in unstable angina/non-ST-elevation myocardial infarction: B-type natriuretic peptide and prognosis in TACTICS-TIMI 18.
Trial report in Journal of the American College of Cardiology, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00521976 (An Investigation of Activated Factor XII), which is not on this map. Cited by 83 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
An Investigation of Activated Factor XII (Fxlla) as a Prognostic Marker.
Who cites it
83 citing papers in PubMed, 2 syntheses or guidelines pooled it, 421 citations in OpenAlex.
- Effects and Safety of Sacubitril/Valsartan for Patients with Myocardial Infarction: A Systematic Review and Meta-Analysis.Journal of healthcare engineering · 2022Pooled it
- Routine invasive strategies versus selective invasive strategies for unstable angina and non-ST elevation myocardial infarction in the stent era.The Cochrane database of systematic reviews · 2016Pooled it
- Role of B-Type Natriuretic Peptide and N-Terminal Prohormone BNP as Predictors of Cardiovascular Morbidity and Mortality in Patients With a Recent Coronary Event and Type 2 Diabetes Mellitus.Journal of the American Heart Association · 2017Trial
- Osteoprotegerin and cardiovascular mortality in patients with non-ST elevation acute coronary syndromes.Heart (British Cardiac Society) · 2012Trial
- Evaluation of N-terminal prohormone B-type natriuretic Peptide in patients with acute coronary syndromes and percutaneous coronary intervention.Journal of clinical hypertension (Greenwich, Conn.) · 2010Trial
- Concurrent evaluation of novel cardiac biomarkers in acute coronary syndrome: myeloperoxidase and soluble CD40 ligand and the risk of recurrent ischaemic events in TACTICS-TIMI 18.European heart journal · 2008Trial
- Lipoprotein-associated phospholipase A2 for early risk stratification in patients with suspected acute coronary syndrome: a multi-marker approach: the North Wuerttemberg and Berlin Infarction Study-II (NOBIS-II).Clinical research in cardiology : official journal of the German Cardiac Society · 2007Trial
- A prospective cohort study of prognostic power of N-terminal probrain natriuretic peptide in patients with non-ST segment elevation acute coronary syndromes.Clinical research in cardiology : official journal of the German Cardiac Society · 2007Trial
- The impact of acute coronary syndrome on long-term survival in cancer patients.Cardio-oncology (London, England) · 2026Article
- Observational
- The predictive value of NT-proBNP/ALB ratio for in-hospital pericardial effusion in young acute myocardial infarction patients.Frontiers in cardiovascular medicine · 2026Article
- Risk Stratification of Acute Chest Pain in Patients With High-Sensitivity Troponin T Below the 99th Percentile: A Long-Term Cohort Study Assessing the Incremental Value of Necrosis and Non-necrosis Biomarkers to Clinical Risk Scores.Journal of the American Heart Association · 2025Observational
- Application of AMR in evaluating microvascular dysfunction after ST-elevation myocardial infarction.Clinical cardiology · 2024Article
- Novel Biomarkers and Their Role in the Diagnosis and Prognosis of Acute Coronary Syndrome.Life (Basel, Switzerland) · 2023Review
- Serially measured high-sensitivity cardiac troponin T, N-terminal-pro-B-type natriuretic peptide, high-sensitivity C-reactive protein, and growth differentiation factor 15 for risk assessment after acute coronary syndrome: the BIOMArCS cohort.European heart journal. Acute cardiovascular care · 2023Observational
- The Prognostic Value of Biomarkers in Non-ST-Elevation Acute Coronary Syndrome Patients that are Treated by an Early Invasive Strategy: Insights from the OPTIMA-2 Trial.Reviews in cardiovascular medicine · 2023Article
- Comparison of Mortality Prediction by the GRACE Score, Multiple Biomarkers, and Their Combination in All-comer Patients with Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.Internal medicine (Tokyo, Japan) · 2023Article
- Serum NT-pro-BNP Levels Predict Cardiovascular Events in Acromegaly Patients.Experimental and clinical endocrinology & diabetes : official journal, German Society of Endocrinology [and] German Diabetes Association · 2022Article
- N-terminal pro-brain natriuretic peptide and adverse outcomes in Chinese patients with hypertrophic cardiomyopathy.Bioscience reports · 2022Observational
- Critical appraisal of the 2020 ESC guideline recommendations on diagnosis and risk assessment in patients with suspected non-ST-segment elevation acute coronary syndrome.Clinical research in cardiology : official journal of the German Cardiac Society · 2021Article
23 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
10 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThis study was designed to evaluate B-type natriuretic peptide (BNP) for risk assessment and clinical decision making over a range of cut points, alone and with cardiac troponin I (cTnI), in patients with non-ST-elevation acute coronary syndromes (ACS).
backgroundB-type natriuretic peptide holds promise for risk stratification. Additional evidence regarding optimal decision limits, use in combination with troponin, and use in targeting therapy is needed before acceptance into clinical use for ACS.
methodsWe evaluated BNP at baseline in 1,676 patients with non-ST-elevation ACS randomized to early invasive versus conservative management.
resultsPatients with elevated BNP (>80 pg/ml; n = 320) were at higher risk of death at seven days (2.5% vs. 0.7%, p = 0.006) and six months (8.4% vs. 1.8%, p < 0.0001). The association between BNP and mortality at six months (adjusted odds ratio [OR] 3.3; 95% confidence interval [CI] 1.7 to 6.3) was independent of important clinical predictors, including cTnI and congestive heart failure (CHF). Patients with elevated BNP had a fivefold higher risk of developing new CHF by 30 days (5.9% vs. 1.0%, p < 0.0001). B-type natriuretic peptide added prognostic information to cTnI, discriminating patients at higher mortality risk among those with negative (OR 6.9; 95% CI 1.9 to 25.8) and positive (OR 4.1; 95% CI 1.9 to 9.0) baseline cTnI results. No difference was observed in the effect of invasive versus conservative management when stratified by baseline levels of BNP (p(interaction) > or = 0.6).
conclusionsElevated BNP (>80 pg/ml) at presentation identifies patients with non-ST-elevation ACS who are at higher risk of death and CHF and adds incremental information to cTnI. Additional work is needed to identify therapies that may reduce the risk associated with increased BNP.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.