predictive value of nt-probnp on maces after acute coronary syndrome

Conditions: Acute Coronary Syndrome; ST-segment Elevation Myocardial Infarction (STEMI); Non-ST-Segment Elevation Myocardial Infarction (NSTEMI); Major Adverse Cardiac Events

Summary: the role of n-terminal pro-b-type natriuretic peptide (nt-probnp) as a cardiac biomarker in predicting short-term major adverse cardiovascular events (maces) in patients with acute coronary syndrome (acs) has been insufficiently reported and remains poorly understood. additionally, the relationship between nt-probnp levels and specific acs subtypes has not been thoroughly examined. therefore, our study investigated the predictive value of high-sensitivity cardiac troponin (hs-ctn) and nt-probnp levels on admission for 6-month maces in patients who presented to the emergency department (ed) with acs and subsequently underwent percutaneous coronary intervention (pci). furthermore, we sought to evaluate the association between maces and specific acs subtypes.

in patients diagnosed with acute coronary syndrome (acs) based on anamnesis, clinical findings, electrocardiogram (ecg), and/or serum high-sensitivity cardiac troponin (hs-ctn) level in the emergency department (ed), blood samples for serum n-terminal pro-b-type natriuretic peptide (nt-probnp) value was additionally taken during transfer to the coronary intensive care unit, and left ventricular ejection fraction (lvef) was calculated by echocardiography before percutaneous coronary intervention (pci). in addition, demographics (age, sex, and smoking status), comorbidities (hypertension, diabetes mellitus \[dm\] and/or coronary artery disease \[cad\]), initial complaints and diagnoses, vital signs (systolic blood pressure \[sbp\], heart rate \[hr\], and peripheral capillary oxygen saturation \[spo2\]), laboratory parameters (serum creatinine, c-reactive protein, and hs-ctn), and acs subtypes (st-elevation myocardial infarction \[stemi\], non-st-elevation myocardial infarction \[nstemi\], or unstable angina pectoris \[usap\]) were obtained during admission. grace risk score was calculated for each patient on admission using eight variables, including age, sbp, hr, and serum creatinine. at the end of the 6-month follow-up period, lvef of surviving patients was assessed by control echocardiography. the short-term maces (e.g., nonfatal ischemic stroke, nonfatal myocardial infarction, cardiovascular mortality, or ed admission due to heart failure) were recorded.

Eligibility criteria:
inclusion criteria: * adult patients (≥18 years old) who were admitted to the emergency department with acute coronary syndrome and underwent percutaneous coronary intervention between september 2023 and february 2024. exclusion criteria: * patients younger than 18 years * patients had no vascular lesions detected on percutaneous coronary intervention, * patients had infective or structural cardiac pathologies (myocarditis, pericarditis, hypertrophic or dilated cardiomyopathies) * patients had chronic heart failure with lvef \<40%, class 3 and 4 in the killip classification * patients had a diagnosis of malignancy, chronic renal failure, chronic liver failure, and a history of multiple trauma or surgery within the last month

Keywords: nt-probnp maces acute coronary syndrome stemi nstemi