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Review
. 2017 Aug;8(4):237-246.
doi: 10.24171/j.phrp.2017.8.4.02. Epub 2017 Aug 31.

Biomarker for the Prediction of Major Adverse Cardiac Events in Patients with Non-ST-Segment Elevation Myocardial Infarction

Ho Sun Shon  1 , Jang-Whan Bae  2 , Kyoung Ok Kim  3 , Eun Jong Cha  4 , Kyung Ah Kim  4
Affiliations
Review

Biomarker for the Prediction of Major Adverse Cardiac Events in Patients with Non-ST-Segment Elevation Myocardial Infarction

Ho Sun Shon et al. Osong Public Health Res Perspect. 2017 Aug.

Abstract

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a well-known biomarker for the diagnosis and prognosis of heart failure, and is directly associated with myocardial dysfunction. We evaluated the prognostic value of NT-proBNP for major adverse cardiac events (MACEs) among patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the Korea Acute Myocardial Infarction Registry during their mid-term follow-up period. In this paper, we analyzed NT-proBNP according to various MACE and level of NT-proBNP. We used multivariate logistic regression to determine the risk factors according to MACE type and NT-proBNP levels, and to identify the cutoff value for each MACE by using the receiver operating characteristic (ROC) curve. NT-proBNP was a significant variable among cardiac deaths (p = 0.016), myocardial infarction (p = 0.000), and coronary artery bypass grafting (CABG) (p = 0.000) in patients with MACE compared with those without MACE. Two-vessel coronary artery disease (CAD) (p = 0.037) and the maximum creatinine kinase (max-CK) (p = 0.031) produced significant results in repeat percutaneous coronary intervention. The area under the ROC curve was found to be statistically significant for cardiac death and CABG. NT-proBNP is a useful predictor for 12-month MACEs among patients with NSTEMI and in those with heart failure. We propose that a new index incorporating NT-proBNP, max-CK, and CAD vessel will be useful as a prognostic indicator of MACEs in the future.

Keywords: NT-proBNP; cardiac biomarker; heart disease; myocardial infarction.

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Conflict of interest statement

CONFLICTS OF INTEREST No potential conflict of interest relevant to this article was reported.

Figures

Figure 1
Figure 1
MACEs that occurred during the 12-month follow-up period after PCI. NSTEMI, non-ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction; MACE, major adverse cardiac event; MI, myocardial infarction; PCI, percutaneous coronary intervention; CABG, coronary artery bypass grafting.
Figure 2
Figure 2
Receiver operating characteristic curve of myocardial infarction in terms of N-terminal pro-brain natriuretic peptide (NT-proBNP).
Figure 3
Figure 3
Receiver operating characteristic curve of repeat percutaneous coronary intervention in terms of N-terminal pro-brain natriuretic peptide (NT-proBNP).
Figure 4
Figure 4
Receiver operating characteristic curve of cardiac death in terms of N-terminal pro-brain natriuretic peptide (NT-proBNP).
Figure 5
Figure 5
Receiver operating characteristic curve of coronary artery bypass grafting in terms of N-terminal pro-brain natriuretic peptide (NT-proBNP).
See this image and copyright information in PMC

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