The Association of Baseline N-terminal Pro-B-type Natriuretic Peptide With Short and Long-term Prognosis Following Percutaneous Coronary Intervention in Non-ST Segment Elevation Acute Coronary Syndrome With Multivessel Coronary Artery Disease: a Retrospective Cohort Study

Abstract

Background: Although several studies have shown that N-terminal pro-B-type natriuretic peptide (NT-proBNP) is strongly correlated with coronary artery lesion complexity as well as prognosis in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients, the prognostic value of NT-proBNP in patients with NSTE-ACS and multivessel coronary artery disease undergoing PCI remains unclear. This study aimed to reveal the relationship between NT-proBNP levels and prognosis among NSTE-ACS patients with multivessel coronary artery disease undergoing successfully percutaneous coronary intervention.Methods: We consecutively enrolled 1022 patients from January 2010 to December 2014. Patients with a diagnosis of NSTE-ACS with multivessel coronary artery disease and NT-proBNP levels were included. The primary outcome was in-hospital all-cause death. The 3-year follow-up all-cause death was also ascertained.Results: A total of 12 (1.2%) deaths occurred during hospitalization. The 4th quartile group of NT-proBNP (>1287 pg/ml) had the highest rate of in-hospital all-cause death (4.3%) (P<0.001). Logistic analyses revealed that increasing NT-proBNP was robustly associated with a higher risk of in-hospital all-cause death (adjusted OR: 2.86, 95% CI=1.16-7.03, P=0.022). NT-proBNP had a good ability to predict in-hospital all-cause death (AUC=0.888, 95% CI=0.834-0.941, P<0.001; cutoff: 1568pg/ml). The cumulative event analyses exhibited a statistically significant relationship between a higher level of NT-proBNP and a higher rate of the long-term all-cause death compared with a lower level of NT-proBNP (P< 0.0001).Conclusions: Increasing NT-proBNP is significant associated with a high risk of in-hospital and long-term all-cause death in NSTE-ACS patients with multivessel coronary artery disease who received percutaneous coronary intervention. NT-proBNP > 1568pg/ml was associated with all-cause, in-hospital death.

Association of N‐terminal pro‐B‐type natriuretic peptide with mortality in elderly (≥80 years) patients undergoing percutaneous coronary intervention

“…In line with previous studies, 20,22,[34][35][36] the proportion of patients with type 2 diabetes, hypertension, atrial fibrillation, and reduced left ventricular systolic function increased with higher NT-proBNP levels, and patients with higher NT-proBNP levels had lower BMI values and more often suffered from NSTEMI as index event. The rather low residual Syntax Score observed in the entire patient cohort demonstrates that complete revascularization was mostly attempted.…”

Brain natriuretic peptide as a biomarker for predicting contrast-induced nephropathy in patients undergoing coronary angiography/intervention: A systematic review and meta-analysis

“…[21,22] Furthermore, brain natriuretic peptide has a prognostic value for cardiovascular morbidity and mortality in patients with CAD. [11,12] Therefore, BNP and NT-proBNP are common clinical test items used before interventional procedures. A Kurtul first reported that NT-proBNP level at admission was an independent predictor of CIN development after PCI in acute coronary syndrome patents.…”

“…Brain natriuretic peptide, a biomarker for cardiac function, is widely used in clinical practice and is closely related to the outcomes of patients with CAD. [11,12] It reflects the state of ventricular wall tension and volume load, and is associated with the renin-angiotensin and sympathetic nervous systems which contribute to the development of CIN. [7] Studies have reported that the brain natriuretic peptide can be viewed as a predictor of CIN.…”