Shon Ho Sun, Bae Jang-Whan, Kim Kyoung Ok, Cha Eun Jong, Kim Kyung Ah
Medical Research Institute, College of Medicine, Chungbuk National University, Cheongju, Korea.
Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea.
Osong Public Health Res Perspect. 2017 Aug;8(4):237-246. doi: 10.24171/j.phrp.2017.8.4.02. Epub 2017 Aug 31.
N-terminal pro-brain natriuretic peptide (NT-proBNP) is a well-known biomarker for the diagnosis and prognosis of heart failure, and is directly associated with myocardial dysfunction. We evaluated the prognostic value of NT-proBNP for major adverse cardiac events (MACEs) among patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the Korea Acute Myocardial Infarction Registry during their mid-term follow-up period. In this paper, we analyzed NT-proBNP according to various MACE and level of NT-proBNP. We used multivariate logistic regression to determine the risk factors according to MACE type and NT-proBNP levels, and to identify the cutoff value for each MACE by using the receiver operating characteristic (ROC) curve. NT-proBNP was a significant variable among cardiac deaths ( = 0.016), myocardial infarction ( = 0.000), and coronary artery bypass grafting (CABG) ( = 0.000) in patients with MACE compared with those without MACE. Two-vessel coronary artery disease (CAD) ( = 0.037) and the maximum creatinine kinase (max-CK) ( = 0.031) produced significant results in repeat percutaneous coronary intervention. The area under the ROC curve was found to be statistically significant for cardiac death and CABG. NT-proBNP is a useful predictor for 12-month MACEs among patients with NSTEMI and in those with heart failure. We propose that a new index incorporating NT-proBNP, max-CK, and CAD vessel will be useful as a prognostic indicator of MACEs in the future.
N末端脑钠肽前体（NT-proBNP）是用于心力衰竭诊断和预后评估的知名生物标志物，且与心肌功能障碍直接相关。我们在韩国急性心肌梗死注册研究中，评估了NT-proBNP对非ST段抬高型心肌梗死（NSTEMI）患者中期随访期间主要不良心脏事件（MACE）的预后价值。在本文中，我们根据各种MACE和NT-proBNP水平分析了NT-proBNP。我们使用多因素逻辑回归来确定根据MACE类型和NT-proBNP水平的危险因素，并通过使用受试者工作特征（ROC）曲线确定每种MACE的临界值。与无MACE的患者相比，NT-proBNP在发生MACE的患者中，是心脏死亡（P = 0.016）、心肌梗死（P = 0.000）和冠状动脉旁路移植术（CABG）（P = 0.000）的显著变量。双支冠状动脉疾病（CAD）（P = 0.037）和最大肌酸激酶（max-CK）（P = 0.031）在重复经皮冠状动脉介入治疗中产生显著结果。ROC曲线下面积在心脏死亡和CABG方面具有统计学意义。NT-proBNP是NSTEMI患者和心力衰竭患者12个月MACE的有用预测指标。我们建议，将NT-proBNP、max-CK和CAD血管纳入的新指标在未来将作为MACE的预后指标有用。
