Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study
Objective: Different culprit plaque phenotypes including plaque rupture (PR) and non-plaque rupture (NPR), and N-Terminal prohormone of brain natriuretic peptide (NT-proBNP) have been reported to influence clinical outcomes in patients with acute coronary syndrome (ACS). We aimed to investigate the...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-12-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/12/466 |
| _version_ | 1797457043414581248 |
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| author | Jiannan Li Runzhen Chen Jinying Zhou Ying Wang Xiaoxiao Zhao Chen Liu Peng Zhou Yi Chen Li Song Shaodi Yan Hongbing Yan Hanjun Zhao |
| author_facet | Jiannan Li Runzhen Chen Jinying Zhou Ying Wang Xiaoxiao Zhao Chen Liu Peng Zhou Yi Chen Li Song Shaodi Yan Hongbing Yan Hanjun Zhao |
| author_sort | Jiannan Li |
| collection | DOAJ |
| description | Objective: Different culprit plaque phenotypes including plaque rupture (PR) and non-plaque rupture (NPR), and N-Terminal prohormone of brain natriuretic peptide (NT-proBNP) have been reported to influence clinical outcomes in patients with acute coronary syndrome (ACS). We aimed to investigate the prognostic implication of the peak and baseline values at admission for NT-proBNP for major adverse cardiovascular events (MACE) in ST-Segment Elevated Myocardial Infarction (STEMI) patients with different plaque phenotype. Methods: A total of 428 patients with STEMI undergoing optical coherence tomography (OCT) were enrolled and divided into four groups: PR/Tertile1-2 NT-proBNP (<i>n</i> = 132), PR/Tertile3 NT-proBNP (<i>n</i> = 65), NPR/Tertile1-2 NT-proBNP (<i>n</i> = 154), NPR/Tertlie3 NT-proBNP (<i>n</i> = 77). Baseline and Peak values of NT-proBNP were obtained in the admission period. The MACEs were defined as the composite of all-cause death, recurrence of myocardial infarction and stroke. Results: High levels for peak NT-proBNP were significantly associated with a higher incidence of MACE and death (Log rank <i>p</i> = 0.037 and 0.0012, respectively). In the subgroup with NPR, a high level for peak NT-proBNP was significantly associated with higher incidence of death (Log rank <i>p</i> = 0.0022) but this association was not significant in the subgroup of PR (Log rank <i>p</i> = 0.24). Though plaque types were not associated with adverse event, the combination of NPR and a higher peak value for NT-proBNP indicated higher incidence of death compared with other groups (Log rank <i>p</i> = 0.0017). The area under the receiver operating characteristic curve for predicting death to evaluate the diagnostic value of the peak value for NT-proBNP and plaque types combined with traditional risk factors was 0.843 (95% CI: 0.805–0.876), which is superior to solely traditional risk factors: NRI (26.8% [95% CI: 0.4–53.1%], <i>p</i> = 0.046) and IDI (5.1% [95% CI: 1.0–9.2%], <i>p</i> = 0.016). Conclusion: STEMI patients with NPR and a high level for peak NT-proBNP showed higher incidence of death. The peak value of NT-proBNP in combination with plaque types can be used in risk stratification and prediction of death in patients with STEMI. |
| first_indexed | 2024-03-09T16:16:31Z |
| format | Article |
| id | doaj.art-1369868d47f842feacf729bf25e7867b |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T16:16:31Z |
| publishDate | 2022-12-01 |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-1369868d47f842feacf729bf25e7867b2023-11-24T15:42:17ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-12-0191246610.3390/jcdd9120466Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography StudyJiannan Li0Runzhen Chen1Jinying Zhou2Ying Wang3Xiaoxiao Zhao4Chen Liu5Peng Zhou6Yi Chen7Li Song8Shaodi Yan9Hongbing Yan10Hanjun Zhao11Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaFuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen 518057, ChinaFuwai Hospital, Chinese Academy of Medical Sciences, Shenzhen 518057, ChinaDepartment of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100037, ChinaObjective: Different culprit plaque phenotypes including plaque rupture (PR) and non-plaque rupture (NPR), and N-Terminal prohormone of brain natriuretic peptide (NT-proBNP) have been reported to influence clinical outcomes in patients with acute coronary syndrome (ACS). We aimed to investigate the prognostic implication of the peak and baseline values at admission for NT-proBNP for major adverse cardiovascular events (MACE) in ST-Segment Elevated Myocardial Infarction (STEMI) patients with different plaque phenotype. Methods: A total of 428 patients with STEMI undergoing optical coherence tomography (OCT) were enrolled and divided into four groups: PR/Tertile1-2 NT-proBNP (<i>n</i> = 132), PR/Tertile3 NT-proBNP (<i>n</i> = 65), NPR/Tertile1-2 NT-proBNP (<i>n</i> = 154), NPR/Tertlie3 NT-proBNP (<i>n</i> = 77). Baseline and Peak values of NT-proBNP were obtained in the admission period. The MACEs were defined as the composite of all-cause death, recurrence of myocardial infarction and stroke. Results: High levels for peak NT-proBNP were significantly associated with a higher incidence of MACE and death (Log rank <i>p</i> = 0.037 and 0.0012, respectively). In the subgroup with NPR, a high level for peak NT-proBNP was significantly associated with higher incidence of death (Log rank <i>p</i> = 0.0022) but this association was not significant in the subgroup of PR (Log rank <i>p</i> = 0.24). Though plaque types were not associated with adverse event, the combination of NPR and a higher peak value for NT-proBNP indicated higher incidence of death compared with other groups (Log rank <i>p</i> = 0.0017). The area under the receiver operating characteristic curve for predicting death to evaluate the diagnostic value of the peak value for NT-proBNP and plaque types combined with traditional risk factors was 0.843 (95% CI: 0.805–0.876), which is superior to solely traditional risk factors: NRI (26.8% [95% CI: 0.4–53.1%], <i>p</i> = 0.046) and IDI (5.1% [95% CI: 1.0–9.2%], <i>p</i> = 0.016). Conclusion: STEMI patients with NPR and a high level for peak NT-proBNP showed higher incidence of death. The peak value of NT-proBNP in combination with plaque types can be used in risk stratification and prediction of death in patients with STEMI.https://www.mdpi.com/2308-3425/9/12/466NT-proBNPplaque ruptureoptical coherence tomographyST-segment elevated myocardial infarction |
| spellingShingle | Jiannan Li Runzhen Chen Jinying Zhou Ying Wang Xiaoxiao Zhao Chen Liu Peng Zhou Yi Chen Li Song Shaodi Yan Hongbing Yan Hanjun Zhao Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study Journal of Cardiovascular Development and Disease NT-proBNP plaque rupture optical coherence tomography ST-segment elevated myocardial infarction |
| title | Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study |
| title_full | Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study |
| title_fullStr | Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study |
| title_full_unstemmed | Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study |
| title_short | Prognostic Value of Admission Peak NT-proBNP Combined with Culprit Plaque Types for Predicting Cardiovascular Risk in ST-Segment Elevated Myocardial Infarction: An Optical Coherence Tomography Study |
| title_sort | prognostic value of admission peak nt probnp combined with culprit plaque types for predicting cardiovascular risk in st segment elevated myocardial infarction an optical coherence tomography study |
| topic | NT-proBNP plaque rupture optical coherence tomography ST-segment elevated myocardial infarction |
| url | https://www.mdpi.com/2308-3425/9/12/466 |
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