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Prognostic value of N-terminal Pro-B-Type natriuretic peptide in patients with intermediate coronary lesions
Chenxi Song1,2, Sheng Yuan1,2, Kongyong Cui1,2
1Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Insights
Elevated N-terminal pro-brain natriuretic peptide (NT-proBNP) levels predict major adverse cardiovascular events (MACE) in patients with intermediate coronary lesions. This finding aids in risk stratification and treatment decisions for these challenging cases.
Area of Science:
- Cardiology
- Biomarkers
- Clinical Risk Stratification
Background:
- Optimal treatment for intermediate coronary lesions (50-70% stenosis) is challenging.
- Identifying biomarkers for major adverse cardiovascular events (MACE) can improve risk assessment.
- N-terminal pro-brain natriuretic peptide (NT-proBNP) is a potential biomarker of interest.
Purpose of the Study:
- To investigate the association between baseline NT-proBNP levels and MACE risk.
- To determine if NT-proBNP can serve as a predictive biomarker in patients with intermediate coronary lesions.
- To guide clinical decision-making for this patient group.
Main Methods:
- 1,187 patients with intermediate coronary lesions and baseline NT-proBNP levels were analyzed.
- MACE was defined as all-cause death or non-fatal myocardial infarction.
- Multivariate Cox regression and restricted cubic spline analyses were employed.
Main Results:
- An increased baseline NT-proBNP level showed a linear association with MACE risk.
- Higher NT-proBNP levels were significantly associated with increased MACE risk (aHR per doubling: 1.412, p=0.0365).
- This association was consistent across various subgroups (age, sex, BMI, diabetes).
Conclusions:
- Elevated NT-proBNP levels are linked to higher MACE risk in patients with intermediate coronary lesions.
- NT-proBNP may function as a valuable biomarker for risk stratification.
- These findings support using NT-proBNP to guide treatment decisions in this population.
Background:
The optimal treatment strategy for patients with coronary intermediate lesions, defined as diameter stenosis of 50-70%, remains a great challenge for cardiologists. Identification of potential biomarkers predictive of major adverse cardiovascular events (MACEs) risk may assist in risk stratification and clinical decision.
Methods:
A total of 1,187 patients with intermediate coronary lesions and available N-terminal pro-brain natriuretic peptide (NT-proBNP) levels were enrolled in the current study. A baseline NT-proBNP level was obtained. The primary endpoint was defined as MACEs, the composite endpoint of all-cause death and non-fatal myocardial infarction. A multivariate Cox regression model was used to explore the association between NT-proBNP level and MACE risk.
Results:
The mean age of the study cohort was 59.2 years. A total of 68 patients experienced MACE during a median follow-up of 6.1 years. Restricted cubic spline analysis delineated a linear relationship between the baseline NT-proBNP level and MACE risk. Both univariate and multivariate analyses demonstrated that an increased NT-proBNP level was associated with an increased risk of MACE [adjusted hazard ratio (HR) per doubling: 1.412, 95% confidence interval (CI): 1.022-1.952, p = 0.0365]. This association remains consistent in clinical meaningful subgroups according to age, sex, body mass index (BMI), and diabetes.
Conclusion:
An increased NT-proBNP level is associated with an increased risk of MACE in patients with intermediate coronary lesions and may serve as the potential biomarker for risk stratification and treatment decision guidance.
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