Prognostic significance of serial N-terminal pro-B-type natriuretic peptide levels in patients with acute myocardial infarction: A prospective study
Authors' conclusion
Early and sequential measurement of NT-proBNP levels could assist in predicting MACE risk. Moreover, the relationship between MACE risk and NT-proBNP levels was U-shaped.
Study context
- Population
- Patients with acute MI undergoing emergency percutaneous coronary intervention (PCI), March 2017–January 2020
- Participants
- 1,105 patients
- Exposure
- NT-proBNP quartile 4 vs quartile 1
- Outcome
- MACE:
- All-cause death
- MI recurrence
- HF rehospitalization
- Follow-up
- 36.8-month follow-up
Main finding
As reported in the abstract
MACE
Quartile 4 vs Quartile 1Hazard ratio (95% CI)P value
NT-proBNP day 0
2.27(1.27–4.08)
P = 0.006NT-proBNP day 7
2.20(1.23–3.94)
P = 0.008- Patients with major adverse cardiovascular events (MACE)
- 175 (15.8%)
- U-shaped relationship between HR for MACE and NT-proBNP on days 2, 3, 7 and peak (P for nonlinearity)
- .007, .006, .004, .009
Observational data: associations, not effects.
Further findings
MI recurrence
- Similar U-shaped relationship with NT-proBNP on days 2 and 3
MACE at 3 years: serial NT-proBNP added to Global Registry of Acute Coronary Events (GRACE) score
- C-index
- 0.711
- Continuous NRI
- 0.192 (95% CI 0.022-0.445)
- IDI
- 0.034 (95% CI 0.016-0.064)
All-cause death at 3 years: NT-proBNP plus GRACE score
- C-index
- 0.801
- Continuous NRI
- 0.373 (95% CI 0.072-0.853)
- IDI
- 0.051 (95% CI 0.025-0.091)
Original publication
Prognostic significance of serial N-terminal pro-B-type natriuretic peptide levels in patients with acute myocardial infarction: A prospective study. Am Heart J. Published 26 April 2023. doi:10.
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