B-type natriuretic peptides in acute coronary syndromes: implications in an aging population

Clin Cardiol. 2012 Nov;35(11):682-5. doi: 10.1002/clc.22035. Epub 2012 Jul 3.


B-type natriuretic peptide (BNP) and N-terminal-proBNP (NT-proBNP) are increasingly recognized as prognostic markers in patients with acute coronary syndrome (ACS). The need for novel and more effective tools for risk assessment cannot be more emphasized than in older patients with ACS given their atypical presentation, multiple comorbidities, and higher risk for mortality and morbidity. Accurate interpretation of B-type NP values in older patients with ACS, however, may be confounded by several aging-related physiologic changes. Advanced age, reduction in body mass, and kidney function and anemia have been associated with higher BNP and NT-proBNP concentrations, and may create challenges with interpreting NP levels in the elderly. This review highlights the need to better understand the physiology of BNP and NT-proBNP in older individuals and their prognostic value in older patients with ACS.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome / blood*
  • Acute Coronary Syndrome / diagnosis
  • Acute Coronary Syndrome / physiopathology
  • Age Factors
  • Aging / blood*
  • Biomarkers / blood
  • Humans
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood
  • Predictive Value of Tests
  • Prognosis
  • Risk Assessment
  • Risk Factors


  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain