Correlates and Prognostic Value of NT-proBNP in Post-Acute Coronary Syndrome Patients with Preserved Left Ventricular Ejection Fraction

AUTHORS

Marta Fontes-Oliveira ORCID 1 , * , Filipe Martins 2 , Luis Gomes 2 , Maria Trepa 1 , Raquel Baggen-Santos 1 , Ricardo Costa 1 , Patricia Rodrigues 1 , Andre Luz 1 , Sofia Cabral 1 , Mario Santos 1 , 3 , 4 , Severo Torres 1

1 Cardiology Department, University Hospital Center of Porto, Porto, Portugal

2 Abel Salazar Biomedical Sciences Institute, University of Porto, Porto, Portugal

3 Physiology and Cardiothoracic Surgery Department, Faculty of Medicine of University of Porto, Porto, Portugal

4 Pulmonary Vascular Disease Unit, University Hospital Center of Porto, Porto, Portugal

How to Cite: Fontes-Oliveira M, Martins F, Gomes L, Trepa M, Baggen-Santos R, et al. Correlates and Prognostic Value of NT-proBNP in Post-Acute Coronary Syndrome Patients with Preserved Left Ventricular Ejection Fraction, Int Cardio Res J. 2019 ; 13(4):e96017.

ARTICLE INFORMATION

International Cardiovascular Research Journal: 13 (4); e96017
Published Online: December 01, 2019
Article Type: Research Article
Received: July 03, 2019
Accepted: September 23, 2019
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Abstract

Background:

Patients with Acute Coronary Syndrome (ACS) with preserved Left Ventricular Ejection Fraction (LVEF) have an incidence of adverse outcomes despite the previously presumed benign prognosis.

Objective:

We hypothesized that NT-pro-BNP could help refine the risk stratification of these patients.

Methods:

In this observational retrospective study, laboratory and clinical data were collected from 232 consecutive patients with ACS and preserved LVEF (> 50%) and no previous history of Heart Failure (HF) at hospital discharge. Associations between NT-proBNP and the composite outcome of HF hospitalization, HF diagnosis de novo, and all-cause mortality were assessed by univariate and multivariable Cox models. Statistical analyses were performed using Stata software, version 12.1 and a two-sided P-value < 0.05 was considered to be statistically significant.

Results:

The NT-proBNP median was 408 [IQR 177-853] pg/mL. Patients with increased NT-proBNP were older and were more likely to be female (P = 0.013), be non-smoker (P = 0.039), have worse renal function (P < 0.001), and have lower hemoglobin concentration (P < 0.001). They had more ST-Elevation Myocardial Infarction (STEMI) and evolved with higher Killip classes (P < 0.001). Increased NT-proBNP levels were also associated with higher peak values of Creatinine Kinase (CK) and troponin (r = 0.36, P < 0.001 and r = 0.37, P < 0.001), higher left ventricular mass (P = 0.021), larger left atria (P = 0.013), and higher prevalence of regional LV hypocontractility (P = 0.012 to P = 0.090). During the 4.2 [2.1-5.4] years of follow-up, the composite outcome occurred in 19 patients. After adjusting for age, sex, and Killip class, NT-proBNP was not associated with the composite outcome (HR = 1.18; 95% CI: 0.78 - 1.78).

Conclusion:

Post-ACS patients with preserved LVEF and increased levels of NT-proBNP were older, had more comorbidities, and presented with a more severe myocardial infarction. However, NT-proBNP levels measured during ACS hospitalization did not predict the clinical adverse outcomes.

© 0, Shiraz University of Medical Sciences.

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