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N-terminal pro-BNP in acute coronary syndrome patients with ST elevation (STE-ACS) versus non ST elevation (NSTE-ACS).

Pro-BNP was synthesized as a pro-hormone by cardiac myocytes then cleaved by enzyme to N-teminal proBNP (NT-proBNP) and BNP (brain naturetic peptide). Conventional cardiac markers, such as troponin-T (Tn -T), and creatine kinase (CK)-MB isozyme, detect the development of minor myocardial necrosis [1]. A direct release of BNP from ischemic cardiomyocytes and ischemia induced by increase in ventricular wall stress was postulated. Natriuretic peptides have cyto-protective effect in myocardium related to cGMP accumulation and opening of ATP-sensitive K+ channels which is potentially exploitable therapeutically [2]. 
 
The objective of this study is to investigate the differences in the secretion of NT-proBNP and conventional cardiac markers in patients with STE-ACS vs. NSTE-ACS as a trial to solve the dilemma of the early detection of myocardial ischemia in NSTE-ACS.