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The Scientific World JournalVolume 2012 2012, Article ID 397915, 7 pages

Clinical Study

Heart Institute InCor, University of São Paulo Medical School, Avenue Enéas de Carvalho de Aguiar 44, 05403-000 São Paulo, SP, Brazil

Institute of Mathematics and Statistics, University of São Paulo, R. do Matão 1010, 05508-090 São Paulo, SP, Brazil

Received 10 October 2011; Accepted 21 November 2011

Academic Editors: D. Carrie and L. G. Graff

Copyright © 2012 Julio Yoshio Takada et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Objectives. Admission hyperglycemia and B-type natriuretic peptide BNP are associated with mortality in acute coronary syndromes, but no study compares their prediction in-hospital death. Methods. Patients with non-ST-elevation myocardial infarction NSTEMI, in-hospital mortality and two-year mortality or readmission were compared for area under the curve AUC, sensitivity SEN, specificity SPE, positive predictive value PPV, negative predictive value NPV, and accuracy ACC of glycemia and BNP. Results. Respectively, AUC, SEN, SPE, PPV, NPV, and ACC for prediction of in-hospital mortality were 0.815, 71.4%, 84.3%, 26.3%, 97.4%, and 83.3% for glycemia = 200 mg-dL and 0.748, 71.4%, 68.5%, 15.2%, 96.8% and 68.7% for BNP = 300 pg-mL. AUC of glycemia was similar to BNP 𝑃 = 0 . 4 1 1 . In multivariate analysis we found glycemia ≥200mg-dL related to in-hospital death 𝑃 = 0 . 0 0 4 . No difference was found in two-year mortality or readmission in BNP or hyperglycemic subgroups. Conclusion. Hyperglycemia was an independent risk factor for in-hospital mortality in NSTEMI and had a good ROC curve level. Hyperglycemia and BNP, although poor in-hospital predictors of unfavorable events, were independent risk factors for death or length of stay >10 days. No relation was found between hyperglycemia or BNP and long-term events.

Autor: Julio Yoshio Takada, Rogério Bicudo Ramos, Solange Desiree Avakian, Soane Mota dos Santos, José Antonio Franchini Ramires, 



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