Abstract
Introduction: The utilization of the biomarker N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) holds diagnostic value for identifying heart failure and acute coronary syndromes. However, its long-term prognostic significance in patients with non-ST-elevation Myocardial Infarction (NSTEMI), a subtype of acute coronary syndromes, remains inadequately explored. Hypothesis: This meta-analysis aims to investigate the correlation between NT-proBNP levels and the subsequent occurrence of adverse clinical outcomes in individuals with NSTEMI. Methods: A systematic search was conducted on PubMed, Google Scholar, Science Direct, Cochrane, and Embase, encompassing articles published until June 2023. The highest recorded NT-proBNP value was utilized for analysis, considering a follow-up duration of at least 30 days. Odds ratios (OR) were synthesized using the random-effects DerSimonian-Laird model, with statistical significance set at a p-value <0.05. Results: The study involved 8 articles, comprising a total of 7,921 patients, of whom 7,161 were diagnosed with NSTEMI. The analysis examined the relationship between NT-proBNP levels and clinical outcomes in NSTEMI patients over an average follow-up period of 19.85 months. Elevated NT-proBNP levels exhibited a significant association with increased odds of Major Adverse Cardiac Events (MACE) [OR 2.56, 95% CI: 1.58-3.53, I2=94.06%, p<0.001], all-cause mortality [OR 2.54, 95% CI: 0.53-4.55, I2=76.96%, p=0.01], and myocardial infarction (MI) [OR 1.10, 95% CI: 0.56-1.63, I2=0.00%, p<0.001]. Conclusions: The elevated NT-proBNP levels in patients with NSTEMI are significantly associated with long-term adverse cardiovascular outcomes. Consequently, NT-proBNP can serve as a valuable tool for assessing the risk of unfavorable cardiac events. However, further extensive investigations are warranted to validate these results on a larger scale.
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