NT-proBNP changes predict outcomes in elderly type 2 myocardial infarction patients

Area of Science:

• Cardiology
• Biomarkers
• Geriatric Medicine

Background:

• N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a key predictor of adverse outcomes.
• Monitoring changes in NT-proBNP levels may offer enhanced risk stratification.
• This study focuses on elderly individuals with type 2 myocardial infarction (MI).

Purpose of the Study:

• To investigate the association between NT-proBNP level changes and adverse outcomes.
• To assess the prognostic value of NT-proBNP dynamics in elderly patients post-type 2 MI.

Main Methods:

• Retrospective analysis of 3007 elderly patients (≥80 years) with type 2 MI (December 2010 - December 2022).
• NT-proBNP change calculated as the difference between baseline and last measurement within 30 days.
• Patients categorized by NT-proBNP change: ≥30% decrease, <30% decrease and ≤10% increase, >10% increase.

Main Results:

• Patients with >10% NT-proBNP increase were older, had higher systolic blood pressure, used loop diuretics, and had higher rates of atrial fibrillation and chronic kidney disease.
• A >10% increase in NT-proBNP was significantly associated with increased risk of incident heart failure (HF), all-cause mortality, and cardiovascular mortality.
• Mortality rates increased progressively with increasing NT-proBNP levels, with the highest risk observed in the >10% increase group.

Conclusions:

• Changes in NT-proBNP levels are valuable for identifying high-risk elderly patients with type 2 MI.
• NT-proBNP dynamics can predict incident heart failure and mortality.
• This biomarker may aid in personalizing therapy optimization for high-risk individuals.