2011•Zhonghua linchuang yishi zazhiRequires access
The influence of serum N-terminal probrain natriuretic peptide levels on long-term prognosis in patients with acute coronary syndrome
Yang Shu-guan
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Abstract
Objective To evaluate the correlations of serum N-terminal probrain natriuretic peptide(NT-proBNP)levels and prognosis in patients with acute coronary syndrome(ACS)during 5-year follow-up.Methods Serum NT-proBNP concentrations were measured by ELISA method within 24 96 h[(32.8±16.9)h] after admission in 76 patients with ACS.The patients were followed up for 5-year,the main adverse cardiovascular events(MACE)were observed and recorded.Results(1)Serum NT-proBNP levels was increased in patients with ACS compared with that in patients with unstable angina(P0.05).The mean value of NT-proBNP concentrations in patients with ACS was(513.51±364.69)pg/ml,the medium value was 421.5 pg/ml.The incidence of MACE was increased in patients whose serum NT-proBNP concentration was higher than the median(P0.001).(2)The study found that the risk of the group of NT-proBNP≥ 421.5 pg/ml had MACE(including death)was higher than the group of NT-proBNP421.5 pg/ml.During follow-up,the recurrent incidence of myocardial ischemia in the group of higher NT-proBNP levels was higher than the low group,the rate were 30.26%(23 cases)and 7.89%(6 cases)(P=0.0002);the rate of heart failure event were 15.79%(12 cases)and 2.63%(2 cases)(P=0.0057).The study found that the patients' mortality was higher in group with higher levels of NT-proBNP,the NT-proBNP level of all victims of 6 cases were higher than the median,while if the NT-proBNP level less than the median there was no death.Multivariate logistic regress analysis revealed that NT-proBNP concentration was correlated with the incidence of MACE during follow-up independently(OR=19.995,95% CI 6.207 64.409)(χ2=25.1894,P=0.0001).(3)Area under the curve(AUC)for NT-proBNP≥421.5 pg/ml in evaluating prognosis of ACS patients was 0.953(positive predictive value 95.3%,negative predictive value 4.7%).Conclusions Serum NT-proBNP level is an indepentent predictor for 5-year MACE rate in patients with ACS.