NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunction

Background: Myocardial infarction and non-obstructive coronary arteries (MINOCA) affects 1 in 9 patients with acute coronary syndrome and has no evidence-based therapy. NT-proBNP is an established biomarker associated with prognosis in heart failure and ischemic heart disease, although there is a pa...

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Main Authors: Robert Sykes, Daniel Doherty, Andrew Morrow, Kenneth Mangion, Ahsan Rushd, Colin Berry
Format: Article
Language:English
Published: Elsevier 2023-09-01
Series:American Heart Journal Plus
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666602223000630
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author Robert Sykes
Daniel Doherty
Andrew Morrow
Kenneth Mangion
Ahsan Rushd
Colin Berry
author_facet Robert Sykes
Daniel Doherty
Andrew Morrow
Kenneth Mangion
Ahsan Rushd
Colin Berry
author_sort Robert Sykes
collection DOAJ
description Background: Myocardial infarction and non-obstructive coronary arteries (MINOCA) affects 1 in 9 patients with acute coronary syndrome and has no evidence-based therapy. NT-proBNP is an established biomarker associated with prognosis in heart failure and ischemic heart disease, although there is a paucity of data in patients with MINOCA. Methods: Prospective study of the diagnostic and clinical utility of measuring NT-proBNP in patients with MINOCA without left ventricular dysfunction or heart failure. Data collection was undertaken for patients with an initial diagnosis of MINOCA following urgent coronary angiography in the Golden Jubilee National Hospital (Clydebank, UK), a tertiary center. Demographics were collected in addition to left ventricular function by transthoracic echocardiography. NT-proBNP was measured from a clinically indicated blood sample obtained during routine venepuncture or within the catheter laboratory. Patient outcomes were collected prospectively by the clinical care team using digital follow-up. Results: Fifty-five patients with an initial diagnosis of MINOCA and left ventricular ejection fraction >40 % were included. NT-proBNP was available in 87 % of patients with a median value of 312 pg/mL (interquartile range: 107, 725). Post-discharge, 40 % (n = 24) of patients were readmitted to the hospital, including 15 with chest pain. NT-proBNP ≥125 pg/mL was associated with rehospitalization (P = 0.02). Two patients died and bleeding complications with concomitant antiplatelet therapy occurred in eight patients. Conclusion: NT-proBNP ≥ 125 pg/mL occurred in 72 % of patients presenting with MINOCA and an ejection fraction > 40% and was associated with rehospitalization.
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spelling doaj.art-0c27a568d69743e2ad0d4d17b014cadf2023-08-25T04:24:51ZengElsevierAmerican Heart Journal Plus2666-60222023-09-0133100311NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunctionRobert Sykes0Daniel Doherty1Andrew Morrow2Kenneth Mangion3Ahsan Rushd4Colin Berry5School of Cardiovascular and Metabolic Health, University of Glasgow, G12 8TA, UK; West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Glasgow, UKWest of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, G12 8TA, UK; West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, G12 8TA, UK; West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Glasgow, UK; Department of Cardiology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde Health Board, Glasgow, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, G12 8TA, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, G12 8TA, UK; West of Scotland Heart and Lung Center, Golden Jubilee National Hospital, Glasgow, UK; Department of Cardiology, Queen Elizabeth University Hospital, NHS Greater Glasgow and Clyde Health Board, Glasgow, UK; Corresponding author at: School of Cardiovascular & Metabolic Health, BHF Glasgow Cardiovascular Research Centre (GCRC), University of Glasgow, 126 University Place, Glasgow, G12 8TA, UK.Background: Myocardial infarction and non-obstructive coronary arteries (MINOCA) affects 1 in 9 patients with acute coronary syndrome and has no evidence-based therapy. NT-proBNP is an established biomarker associated with prognosis in heart failure and ischemic heart disease, although there is a paucity of data in patients with MINOCA. Methods: Prospective study of the diagnostic and clinical utility of measuring NT-proBNP in patients with MINOCA without left ventricular dysfunction or heart failure. Data collection was undertaken for patients with an initial diagnosis of MINOCA following urgent coronary angiography in the Golden Jubilee National Hospital (Clydebank, UK), a tertiary center. Demographics were collected in addition to left ventricular function by transthoracic echocardiography. NT-proBNP was measured from a clinically indicated blood sample obtained during routine venepuncture or within the catheter laboratory. Patient outcomes were collected prospectively by the clinical care team using digital follow-up. Results: Fifty-five patients with an initial diagnosis of MINOCA and left ventricular ejection fraction >40 % were included. NT-proBNP was available in 87 % of patients with a median value of 312 pg/mL (interquartile range: 107, 725). Post-discharge, 40 % (n = 24) of patients were readmitted to the hospital, including 15 with chest pain. NT-proBNP ≥125 pg/mL was associated with rehospitalization (P = 0.02). Two patients died and bleeding complications with concomitant antiplatelet therapy occurred in eight patients. Conclusion: NT-proBNP ≥ 125 pg/mL occurred in 72 % of patients presenting with MINOCA and an ejection fraction > 40% and was associated with rehospitalization.http://www.sciencedirect.com/science/article/pii/S2666602223000630MINOCAAcute coronary syndromeMyocardial infarctionInterventional cardiologyNon-obstructive coronary artery disease
spellingShingle Robert Sykes
Daniel Doherty
Andrew Morrow
Kenneth Mangion
Ahsan Rushd
Colin Berry
NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunction
American Heart Journal Plus
MINOCA
Acute coronary syndrome
Myocardial infarction
Interventional cardiology
Non-obstructive coronary artery disease
title NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunction
title_full NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunction
title_fullStr NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunction
title_full_unstemmed NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunction
title_short NT-proBNP in patients presenting with myocardial infarction and non-obstructive coronary arteries without left ventricular systolic dysfunction
title_sort nt probnp in patients presenting with myocardial infarction and non obstructive coronary arteries without left ventricular systolic dysfunction
topic MINOCA
Acute coronary syndrome
Myocardial infarction
Interventional cardiology
Non-obstructive coronary artery disease
url http://www.sciencedirect.com/science/article/pii/S2666602223000630
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