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Prognostic Value of N-Terminal Pro-B-Type Natriuretic Peptide and High-Sensitivity C-Reactive Protein in Patients

Ye-Xuan Cao1,2, Sha Li1, Hui-Hui Liu1

  • 1Cardiovascular Metabolism Center, State Key Laboratory of Cardiovascular Disease, Fu Wai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Frontiers in Cardiovascular Medicine
|March 14, 2022
PubMed

Insights

N-terminal pro-B-type natriuretic peptide (NT-proBNP) predicts major adverse cardiovascular events (MACE) in patients with prior myocardial infarction (MI). Combining NT-proBNP with high-sensitivity C-reactive protein (hs-CRP) improves risk stratification for these high-risk patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Clinical Risk Stratification

Background:

  • Patients with prior myocardial infarction (MI) face a poor prognosis.
  • Stratifying risk for recurrent major adverse cardiovascular events (MACE) is crucial.
  • N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) are potential cardiovascular risk factors.

Purpose of the Study:

  • To evaluate the prognostic value of NT-proBNP and hs-CRP.
  • To assess their combined predictive importance in post-MI patients.
  • To determine their role in stratifying risk for recurrent MACE.

Main Methods:

  • Prospective enrollment of 3,306 post-MI patients.
  • Assessment of recurrent MACE over a 4-year follow-up.
  • Multivariable Cox regression analysis to determine hazard ratios (HR) and 95% confidence intervals (CI).

Main Results:

  • Elevated NT-proBNP significantly correlated with MACE, hard endpoints, cardiac mortality, and all-cause mortality.
  • hs-CRP was not an independent predictor after adjusting for NT-proBNP.
  • Combining high NT-proBNP and hs-CRP levels increased MACE likelihood by 3.27 times; improved prognostic model performance.

Conclusions:

  • Increased NT-proBNP levels are linked to worse long-term outcomes in post-MI patients.
  • The combination of NT-proBNP and hs-CRP offers incremental value for risk stratification.
  • This combined approach enhances the prediction of recurrent MACE in this population.
Abstract

Keywords:
NT-proBNPcardiovascular eventshs-CRPmyocardial infarctionprognosis

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