Abstract
Background The prognostic significance of the amino-terminal fragment of the prohormone brain-type natriuretic peptide (NT-proBNP) in patients with ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) has not been fully elucidated. Major adverse cardiovascular events (MACEs) are clinically viable indicators for the accurate, rapid, and safe evaluation of patients with STEMI. This study was designed to investigate the relationship between NT-proBNP levels and the occurrence of short-term MACEs in patients with STEMI who underwent emergency PCI. Methods This prospective cohort study included 405 patients with STEMI aged 20–90 years who underwent emergency PCI at the First People's Hospital of Changde City from April 6, 2017, to May 31, 2019. Stent thrombosis, reinfarction, congestive heart failure, unstable angina, and cardiac death were considered as MACEs in this study. The target-independent and -dependent variables were NT-proBNP at baseline and MACE, respectively. Results There were 28.25% of MACEs. Age, number of implanted stents, Killip class, infarction-related artery, applied intra-aortic balloon pump (IABP), creatine kinase (CK) peak value, CK-MB peak value, TnI peak value, and ST-segment resolution were independently associated with MACE (P < 0.05). In a multivariate model, after adjusting all potential covariates, Log2 NT-proBNP levels remained significantly associated with MACE, with an inflection point of 11.66. The effect sizes and confidence intervals of the left and right sides of the inflection point were 1.07 and 0.84–1.36 (P=0.5730) and 3.47 and 2.06–5.85 (P < 0.0001), respectively. Conclusions In patients with STEMI who underwent PCI, Log2 NT-proBNP was positively correlated with MACE within 1 month when the Log2 NT-proBNP was >11.66 (NT-proBNP >3.236 pg/mL).
Highlights
Zuoan Qin,1,2 Yaoyao Du,3 Quan Zhou,4 Xuelin Lu,5 Li Luo,1 Zhixiang Zhang,1 Ning Guo,1 and Liangqing Ge 1
Major adverse cardiovascular events (MACEs) are clinically viable indicators for the accurate, rapid, and safe evaluation of patients with segment elevation myocardial infarction (STEMI). is study was designed to investigate the relationship between NT-proBNP levels and the occurrence of short-term MACEs in patients with STEMI who underwent emergency percutaneous coronary intervention (PCI)
NT-proBNP is used as a biomarker to predict both short- and long-term mortality in patients with the acute coronary syndrome (ACS), and it is closely linked to the levels of myocardial ischemia and cardiac function in ACS patients [2]. e term “major adverse cardiovascular events” (MACEs) has no concrete definition, but over time, various definitions have been used in cardiovascular research with MACE selected as the primary or secondary endpoint
Summary
Zuoan Qin ,1,2 Yaoyao Du, Quan Zhou, Xuelin Lu, Li Luo, Zhixiang Zhang, Ning Guo, and Liangqing Ge 1. Is study was designed to investigate the relationship between NT-proBNP levels and the occurrence of short-term MACEs in patients with STEMI who underwent emergency PCI. MACE includes heart failure (HF), recurrent angina, nonfatal reinfarction, rehospitalization for cardiovascular-related illness, and repeat percutaneous coronary intervention (PCI) [5]. It can include unscheduled coronary revascularization, stroke, reinfarction, and all-cause death mortality [6]. E objective of this study was to investigate the association between NTproBNP levels and MACE and to assess the clinical significance of short-term MACE in patients with STEMI who underwent emergency PCI MACE is a clinically viable parameter for the accurate, rapid, and safe evaluation of myocardial perfusion [8]. e prognostic role of NT-proBNP in STEMI has been rarely reported. e relationship between NT-proBNP and MACE has not previously been investigated in patients with STEMI undergoing emergency PCI. e objective of this study was to investigate the association between NTproBNP levels and MACE and to assess the clinical significance of short-term MACE in patients with STEMI who underwent emergency PCI
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