Implications of N-terminal pro-B-type natriuretic peptide in patients with three-vessel disease

Zhang, Ce; Jiang, Lin; Xu, Lianjun; Tian, Jianwei; Liu, Junhao; Zhao, Xueyan; Feng, Xinxing; Wang, Dong; Yin, Zhang; Sun, Kai; Xu, Bo; Zhao, Wei; Hui, Rutai; Gao, Runlin; Yuan, Jinqing; Song, Lei

doi:10.1093/eurheartj/ehz394

Cited by 45 publications

(40 citation statements)

References 24 publications

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“…NT-pro-BNP was measured using a commercial sandwich enzyme immunoassay as described previously 15 at hospital admission before the procedure. Other biochemical indicators, including serum blood lipid profiles, blood glucose, Cr, urea nitrogen, uric acid, and levels of electrolytes, were measured as a part of standard clinical care.…”

Section: Detection Of Nt-pro-bnp and Other Biochemical Indicatorsmentioning

confidence: 99%

“…12 In addition, N-terminal pro-B-type natriuretic peptide (NT-proBNP), which is synthesized in cardiomyocytes and released into the circulation, was reported to be a potential biomarker for risk stratification in both ACS patients 13,14 and patients with three-vessel disease. 15 In addition, NT-proBNP can improve the discrimination and reclassification of the C-ACS risk score in ACS patients 16 and of the SYNTAX score II for mortality prediction in patients with three-vessel disease. 15 Therefore, whether a novel prediction model developed using important biomarkers will be more effective needs to be explored.…”

Section: Introductionmentioning

confidence: 99%

“…15 In addition, NT-proBNP can improve the discrimination and reclassification of the C-ACS risk score in ACS patients 16 and of the SYNTAX score II for mortality prediction in patients with three-vessel disease. 15 Therefore, whether a novel prediction model developed using important biomarkers will be more effective needs to be explored.…”

Section: Introductionmentioning

confidence: 99%

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A Novel ABC Score Predicts Mortality in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Who underwent Percutaneous Coronary Intervention

et al. 2020

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Objective In the present study, we aimed to establish a novel score to predict long-term mortality of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients who underwent percutaneous coronary intervention (PCI). Methods A total of 2,174 NSTE-ACS patients from the CORFCHD-ZZ study were enrolled as the derivation cohort. The validation cohort including 1,808 NSTE-ACS patients were from the CORFCHD-PCI study. Receiver operating characteristic analysis and area under the curve (AUC) evaluation were used to select the candidate variables. The model performance was validated internally and externally. The primary outcome was cardiac mortality (CM). We also explored the model performance for all-cause mortality (ACM). Results Initially, 28 risk factors were selected and ranked according to their AUC values. Finally, we selected age, N-terminal pro-B-type natriuretic peptide, and creatinine to develop a novel prediction model named “ABC” model. The ABC model had a high discriminatory ability for both CM (C-index: 0.774, p < 0.001) and ACM (C-index: 0.758, p < 0.001) in the derivation cohort. In the validation cohort, the C-index of CM was 0.802 (p < 0.001) and that of ACM was 0.797 (p < 0.001), which suggested good discrimination. In addition, this model had adequate calibration in both the derivation and validation cohorts. Furthermore, the ABC score outperformed the GRACE score to predict mortality in NSTE-ACS patients who underwent PCI. Conclusion In the present study, we developed and validated a novel model to predict mortality in patients with NSTE-ACS who underwent PCI. This model can be used as a credible tool for risk assessment and management of NSTE-ACS after PCI.

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Section: Detection Of Nt-pro-bnp and Other Biochemical Indicatorsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Novel ABC Score Predicts Mortality in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Who underwent Percutaneous Coronary Intervention

et al. 2020

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“…B-type natriuretic peptide (BNP) or N-terminal pro-BNP (NT-proBNP) may be useful for the diagnosis and evaluation of the severity of heart failure in the setting of ACS [14,15]. Systematic assessment of other biomarkers, such as C-reactive protein or copeptin, though associated with outcomes following ACS, is no longer recommended as their prognosis value compared to BNP/NT-proBNP or the Global registry of Acute Coronary Events (GRACE) score remains limited [16][17][18].…”

Section: Other Biomarkersmentioning

confidence: 99%

Diagnosis and Management of Acute Coronary Syndrome: What is New and Why? Insight From the 2020 European Society of Cardiology Guidelines

Guedeney

Collet

2020

JCM

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The management of acute coronary syndrome (ACS) has been at the center of an impressive amount of research leading to a significant improvement in outcomes over the last 50 years. The 2020 European Society of Cardiology (ESC) Guidelines for the management of patients presenting without persistent ST-segment elevation myocardial infarction have incorporated the most recent breakthroughs and updates from large randomized controlled trials (RCT) on the diagnosis and management of this disease. The purpose of the present review is to describe the main novelties and the rationale behind these recommendations. Hence, we describe the accumulating evidence against P2Y12 receptors inhibitors pretreatment prior to coronary angiography, the preference for prasugrel as leading P2Y12 inhibitors in the setting of ACS, and the numerous available antithrombotic regimens based on various durations of dual or triple antithrombotic therapy, according to the patient ischemic and bleeding risk profiles. We also detail the recently implemented 0 h/1 h and 0 h/2 h rule in, rule out algorithms and the growing role of computed coronary tomography angiography to rule out ACS in patients at low-to-moderate risk.

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“…Study from Berin R et al also displayed that serum NT-proBNP was the strongest predictor of long-term mortality in patients with chronic HF (HR 3.76, 95% Cl, 1.20-11.80; P = 0.008) 20 . In addition, higher NT-proBNP levels were strongly associated with increased risks of all-cause death, cardiac death, and MACCE (P < 0.01) in CAD patients with three-vessel disease 21 and has been considered as a useful biomarker for risk strati cation and therapeutic decision-making. The present study found that there was a wide range of NT-proBNP values in the ACS patients undergoing successful PCI and with LVEF ≥ 50%.…”

Section: Prediction Of Maccementioning

confidence: 99%

Association of NT-proBNP and Subsequent Major Adverse Cardiovascular and Cerebral Events in Patients with Successful PCI for ACS and Normal LVEF

Wang

Zhao

Chen

et al. 2020

Preprint

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Abstract Background: Does N-Terminal pro-brain natriuretic peptide (NT-proBNP) predict subsequent major adverse cardiovascular and cerebral event (MACCE) in patients received successful percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) and had normal left ventricular ejection fraction (LVEF)? Methods: 3986 ACS patients were divided into 4 groups based on the quartile (Q) values of peak NT-proBNP measured during hospitalization. All patients were followed for MACCE, a composite of all-cause death, non-fatal myocardial infarction (MI) or stroke, and heart failure requiring hospitalization (HFRH), during a median of 35 months. The incidence of MACCE was compared among Q1-Q4. Receiver operation characteristic curves (ROC) were generated to compare the area under the curve (AUC) for MACCE, cardiovascular (CV) death and HFRH by adding NT-proBNP to the TIMI (thrombolysis in myocardial infarction) risk score.Results: The incidences of MACCE (5.6%, 9.1%, 13.0%, 20.1%, P <0.001), all-cause death (1.0%, 2.5%, 4.1%, 8.4%, P <0.001), non-fatal MI (2.0%,3.4%,4.8%,6.2%, P <0.001) and HFRH (1.5%, 2.3%, 4.1%, 5.9%, P <0.001) were significantly increased from Q1 to Q4, but, not stroke (1.4%, 1.4%, 1.3%, 2.1%, P =0.438). Each median level (337pg/ml) increase in NT-proBNP was significantly and independently associated with increased risk of MACCE (HR 1.02, 95%CI, 1.01-1.03; P <0.001). Compared with TIMI (thrombolysis in myocardial infarction) risk score alone, TIMI+NT-proBNP showed improved AUCs: CV death (0.76 vs. 0.72, P =0.0008), and HFRH (0.68 vs. 0.66, P =0.0017), MACCE (0.70 vs. 0.69, P =0.0012), respectively. Conclusion: NT-proBNP was significantly and independently associated with increased risk of subsequent MACCE in 3 years in ACS patients who received successful PCI and had normal LVEF, and improved the prognosis of major adverse events in addition to the TIMI risk score.

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Implications of N-terminal pro-B-type natriuretic peptide in patients with three-vessel disease

Cited by 45 publications

References 24 publications

A Novel ABC Score Predicts Mortality in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Who underwent Percutaneous Coronary Intervention

A Novel ABC Score Predicts Mortality in Non-ST-Segment Elevation Acute Coronary Syndrome Patients Who underwent Percutaneous Coronary Intervention

Diagnosis and Management of Acute Coronary Syndrome: What is New and Why? Insight From the 2020 European Society of Cardiology Guidelines

Association of NT-proBNP and Subsequent Major Adverse Cardiovascular and Cerebral Events in Patients with Successful PCI for ACS and Normal LVEF

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