Ma Jinling, Li Ang, Bian Suyan
Department of Geriatric Cardiology, the Second Medical Center, National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, No. 28, Fuxing Road, Haidian District, Beijing, 100853, China.
BMC Geriatr. 2025 Jul 16;25(1):535. doi: 10.1186/s12877-025-06169-0.
N-terminal pro-B-type natriuretic peptide (NT-proBNP) is useful to predict adverse outcomes. Change in NT-proBNP level may provide additional actionable risk assessment information. This study aimed to determine the association of change in NT-proBNP level with adverse outcomes among elderly individuals with type 2 myocardial infarction (MI).
A retrospective analysis was conducted among elderly individuals with type 2 MI between December 2010 and December 2022. Change of NT-proBNP level was determined as the difference between the baseline and last measurement obtained during the period of 30 days.
A total of 3007 participants aged 80 years and older were included. The patients were divided in accordance with the change in NT-proBNP level into those with NT-proBNP change ≥ 30% decrease, NT-proBNP change < 30% decrease and ≤ 10% increase, and NT-proBNP change > 10% increase. The patients with NT-proBNP change > 10% increase were older, had higher systolic blood pressure, loop diuretics use, and higher incidence of atrial fibrillation and chronic kidney disease. The quartile of change in NT-proBNP > 10% increase was markedly associated with increased risk of incident HF, as well as all-cause and cardiovascular mortality. The incidence rate of mortality increased in a graded fashion with change in NT-proBNP level. The Kaplan-Meier event-free curves showed that patients with NT-proBNP change > 10% increase had the highest risk, followed by those with NT-proBNP change < 30% decrease and ≤ 10% increase, and NT-proBNP change ≥ 30% decrease.
The change in NT-proBNP level can be used for identifying patients at a high risk of incident HF, as well as cardiovascular and all-cause mortality in elderly individuals with type 2 MI. It may be a promising biomarker to guide personalized therapy optimization.
N 末端 B 型利钠肽原（NT-proBNP）有助于预测不良结局。NT-proBNP 水平的变化可能提供额外的可采取行动的风险评估信息。本研究旨在确定 2 型心肌梗死（MI）老年患者 NT-proBNP 水平变化与不良结局之间的关联。
对 2010 年 12 月至 2022 年 12 月期间的 2 型 MI 老年患者进行回顾性分析。NT-proBNP 水平变化定义为 30 天内基线值与最后一次测量值之间的差值。
共纳入 3007 名 80 岁及以上的参与者。根据 NT-proBNP 水平变化将患者分为 NT-proBNP 变化≥30%降低、NT-proBNP 变化<30%降低且≤10%升高以及 NT-proBNP 变化>10%升高三组。NT-proBNP 变化>10%升高的患者年龄更大，收缩压更高，使用袢利尿剂，房颤和慢性肾脏病的发生率更高。NT-proBNP 变化>10%升高的四分位数与新发心力衰竭风险增加以及全因和心血管死亡率显著相关。死亡率发生率随 NT-proBNP 水平变化呈分级增加。Kaplan-Meier 无事件曲线显示，NT-proBNP 变化>10%升高的患者风险最高，其次是 NT-proBNP 变化<30%降低且≤10%升高的患者，NT-proBNP 变化≥30%降低的患者风险最低。
NT-proBNP 水平变化可用于识别 2 型 MI 老年患者发生新发心力衰竭、心血管和全因死亡的高风险患者。它可能是指导个性化治疗优化的一个有前景的生物标志物。
