Plasma N-terminal pro-B-type natriuretic peptide for prediction of death or nonfatal myocardial infarction following percutaneous coronary intervention

被引:47
作者
de Winter, RJ
Stroobants, A
Koch, KT
Bax, M
Schotborgh, CE
Mulder, KJ
Sanders, GT
van Straalen, JP
Fischer, J
Tijssen, JGP
Piek, JJ
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Cardiol, NL-1100 DD Amsterdam, Netherlands
[2] Univ Amsterdam, Acad Med Ctr, Dept Clin Chem, NL-1100 DD Amsterdam, Netherlands
关键词
D O I
10.1016/j.amjcard.2004.08.023
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
B-type natriuretic peptide (BNP) and the N-terminus of pro-BNP (NT-pro-BNP) have prognostic value in patients with heart failure and patients with acute coronary syndromes. Little is known about the prognostic value of baseline NT-pro-BNP alone or in combination with C-reactive protein (CRP) for clinical outcome after percutaneous coronary intervention (PCI). Within a single center registry of contemporaneous PCI, we investigated the prognostic value of baseline plasma NT-pro-BNP and CRP concentrations for the prediction of death or nonfatal myocardial infarction (MI) during 12 to 14 months of follow-up. Among 1, 172 consecutive patients, the occurrence of death or MI increased significantly with baseline NT-pro-BNP before PCI (first quartile 0 of 294, second quartile. 6 of 291 [2.1%], third quartile 4 of 294 [1.4%], fourth quartile 22 of 293 [7.5%)]; p <0.0001). NT-pro-BNP in the top quartile significantly predicted death (odds ratio [OR] 13.37, 95% confidence interval [Cl;] 4.50 to 40.38, p <0.0001) and was associated with nonfatal Ml (OR 2.53, 95% Cl 0.77 to 8.34, p = 0.22) An abnormal CRP was significantly associated with death (OR 3.47, 95% Cl 1.26 to 9.54, p = 0.019). Stepwise multivariate logistic regression analysis identified age >65 years and NT-pro-BNP as independent significant predictors of death/Ml (age OR 3.18, 95% Cl 1.32 to 7.67, p = 0.01; NT-pro-BNP OR 4.57, 95% Cl 2.07 to 10.10, p = 0.0001). Baseline NT-pro-BNP before PCl provides important, independent prognostic information for the occurrence of death or nonfatal MI during long-term follow-up. (C) 2004 by Excerpta Medica Inc.
引用
收藏
页码:1481 / 1485
页数:5
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