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Plasma BNP Levels and Diuretics Use as Predictors of Cardiovascular Events in Patients with Myocardial Infarction and

Kazuhiro Shindo1, Hiroki Fukuda1, Tatsuro Hitsumoto1

  • 1Department of Clinical Research and Development, National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shinmachi, Suita, Osaka, Japan.

Cardiovascular Drugs and Therapy
|February 21, 2020
PubMed

Insights

High plasma BNP levels predict cardiovascular events like heart failure and myocardial infarction in patients with impaired glucose tolerance. Diuretic use also predicts these events but not coronary stenosis progression.

Area of Science:

  • Cardiology
  • Endocrinology
  • Medical Informatics

Background:

  • Impaired glucose tolerance (IGT) is a risk factor for cardiovascular events.
  • Alpha-glucosidase inhibitors did not prevent cardiovascular events in patients with myocardial infarction (MI) and IGT in the ABC study.
  • Identifying clinical factors for cardiovascular events in MI patients with IGT is crucial.

Purpose of the Study:

  • To identify clinical factors predicting cardiovascular events in patients with myocardial infarction (MI) and impaired glucose tolerance (IGT).

Main Methods:

  • Utilized an artificial intelligence (AI)-based data mining method, the limitless-arity multiple testing procedure.
  • Analyzed 385,391 combinations of fewer than four clinical parameters in 853 patients.
  • Verified findings using Kaplan-Meier curves.

Main Results:

  • Identified 380 predictive combinations for hospitalization (all-cause, heart failure, non-fatal MI) and revascularization (PCI/CABG).
  • Plasma BNP levels ≥ 200 pg/dl or diuretic use predicted all-cause hospitalization, worsening heart failure, and non-fatal MI.
  • Plasma BNP levels ≥ 200 pg/dl uniquely predicted hospitalization for PCI/CABG, indicating a role in coronary stenosis progression.

Conclusions:

  • High plasma BNP levels predict coronary stenosis, recurrent MI, and worsening heart failure in MI patients with IGT.
  • Diuretic use predicts non-fatal MI and worsening heart failure but not coronary stenosis progression.
  • Plasma BNP levels are a key predictor of adverse cardiovascular outcomes and need for revascularization in this patient group.
Abstract

Keywords:
Artificial intelligence (AI)Big dataCoronary eventsPlasma BNP levelPrevious myocardial infarctionbased data mining method

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