Gao X Y, Chen H, Ding X S, Wu S S, Wei W, Li H W
Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
National Clinical Research Center of Digestive Diseases, Beijing 100050, China.
Zhonghua Xin Xue Guan Bing Za Zhi. 2019 Feb 24;47(2):117-122. doi: 10.3760/cma.j.issn.0253-3758.2019.02.008.
To explore the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on admission on left ventricular ejection fraction (LVEF) and the in-hospital major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients with unstable angina (UA). Data of 2 972 consecutive hospitalized patients with UA in Beijing Friendship Hospital from January 2013 to September 2017 were retrospective analyzed. Patients were divided into 4 groups according to the level of NT-proBNP on admission: 733 cases with NT-proBNP lower than 61 ng/L, 749 cases with NT-proBNP between 61 and 133 ng/L, 747 cases with NT-proBNP between 133 and 326 ng/L, and 743 cases with NT-proBNP higher than 326 ng/L. LVEF and in-hospital MACCE were compared among 4 groups and the predictive value of NT-proBNP on admission on LVEF and in-hospital MACCE was determined by multiple logistical regression analysis. LVEF value became lower with increasing on admission NT-proBNP value ((68.4±4.8)%, (68.2±5.2)%, (67.2±6.7)% and (62.6±10.4)%, 77.98, 0.01), while in-hospital MACCE was higher with increasing on admission NT-proBNP value (3.4% (25/733), 3.5% (26/749), 5.5% (41/747) and 7.3% (54/743), χ(2)=16.23, 0.01) in NT-proBNP lower than 61 ng/L, NT-proBNP between 61 and 133 ng/L, NT-proBNP between 133 and 326 ng/L, and NT-proBNP higher than 326 ng/L group. Multiple logistic regression analysis showed that on admission NT-proBNP was an independent predictor for LVEF50% ((β)=5.875, 95 3.382-10.207, 0.001), but not predictor for in-hospital MACCE ((β)=0.783, 95 0.400-1.996, 0.783). The on admission NT-proBNP level is an independent predictor of left ventricular systolic dysfunction (LVEF50%), but not an independent predictor of total in-hospital MACCE in hospitalized patients with UA.
探讨入院时N末端B型利钠肽原(NT-proBNP)对不稳定型心绞痛(UA)住院患者左心室射血分数(LVEF)及院内主要不良心脑血管事件(MACCE)的预测价值。回顾性分析2013年1月至2017年9月在北京友谊医院连续住院的2972例UA患者的数据。根据入院时NT-proBNP水平将患者分为4组:NT-proBNP低于61 ng/L的733例,NT-proBNP在61至133 ng/L之间的749例,NT-proBNP在133至326 ng/L之间的747例,NT-proBNP高于326 ng/L的743例。比较4组患者的LVEF及院内MACCE情况,并通过多因素logistic回归分析确定入院时NT-proBNP对LVEF及院内MACCE的预测价值。随着入院时NT-proBNP值升高,LVEF值降低(分别为(68.4±4.8)%、(68.2±5.2)%、(67.2±6.7)%和(62.6±10.4)%,F=77.98,P=0.01),而院内MACCE随着入院时NT-proBNP值升高而增加(NT-proBNP低于61 ng/L组为3.4%(25/733),NT-proBNP在61至133 ng/L之间组为3.5%(26/749),NT-proBNP在133至326 ng/L之间组为5.5%(41/747),NT-proBNP高于326 ng/L组为7.3%(54/743),χ²=16.23,P=0.01)。多因素logistic回归分析显示,入院时NT-proBNP是LVEF<50%的独立预测因素(β=5.875,95%CI:3.382-10.207,P=0.001),但不是院内MACCE的预测因素(β=0.783,95%CI:0.400-1.996,P=0.783)。入院时NT-proBNP水平是UA住院患者左心室收缩功能障碍(LVEF<50%)的独立预测因素,但不是院内总MACCE的独立预测因素。