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Relationship between serum potassium concentration, NT-pro-BNP, and risk of MACE in elderly patients with chronic
1Department of Cardiology, The 95th Hospital of Putian, Fujian Province, China.
Insights
Low serum potassium and high NT-pro-BNP levels predict major adverse cardiovascular events (MACE) in elderly heart failure patients post-PCI. Combining these markers improves risk prediction for early identification.
Area of Science:
- Cardiology
- Biomarker Research
- Geriatric Medicine
Background:
- Chronic heart failure (CHF) poses significant risks, especially in elderly populations undergoing percutaneous coronary intervention (PCI).
- Identifying reliable predictors of short-term adverse cardiovascular events is crucial for managing these high-risk patients.
- Serum potassium and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) are potential biomarkers requiring further investigation in this context.
Purpose of the Study:
- To investigate the association between serum potassium, NT-pro-BNP levels, and short-term major adverse cardiovascular events (MACE) in elderly CHF patients after PCI.
- To evaluate the predictive value of serum potassium and NT-pro-BNP, individually and in combination, for MACE.
- To explore the dose-response relationship between these biomarkers and MACE risk.
Main Methods:
- Prospective study of 124 elderly patients with CHF after PCI, followed for 3 months.
- Data collection included clinical characteristics, echocardiography, and laboratory indices.
- Multivariate logistic regression, restricted cubic spline (RCS), and receiver operating characteristic (ROC) curve analyses were employed.
Main Results:
- Elevated NT-pro-BNP levels were an independent risk factor for MACE (OR=1.27 per log-unit increase).
- Increased serum potassium concentration was independently associated with a lower MACE risk (OR=0.82 per 0.1 mmol/L increase).
- Combined assessment of serum potassium and NT-pro-BNP yielded a higher predictive value (AUC=0.73) than either biomarker alone.
Conclusions:
- Hypokalemia and elevated NT-pro-BNP levels are linked to increased short-term MACE risk in elderly CHF patients post-PCI.
- The combination of serum potassium and NT-pro-BNP offers enhanced clinical utility for early risk stratification.
- This combined approach aids in identifying high-risk individuals for timely intervention.
Background:
This study aimed to investigate the association between serum potassium concentration, N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels, and short-term major adverse cardiovascular events (MACE) in elderly patients with chronic heart failure (CHF) after percutaneous coronary intervention (PCI), and to evaluate their predictive value.
Methods:
General clinical characteristics, echocardiographic parameters, and laboratory indices were collected from 124 enrolled patients. All patients were followed for 3 months beginning immediately after PCI, encompassing both the in-hospital and post-discharge periods. According to the occurrence of MACE (defined as cardiovascular death, non-fatal myocardial infarction, stroke, or rehospitalization due to worsening heart failure) during follow-up, patients were categorized into a MACE group (n=44) and a non-MACE group (n=80). Multivariate logistic regression analysis was performed to identify independent factors associated with MACE. Restricted cubic spline (RCS) analysis was used to evaluate the dose-response relationships between serum potassium concentration, NT-pro-BNP levels, and MACE risk. Receiver operating characteristic (ROC) curve analysis was conducted to assess the predictive performance of each indicator individually and in combination.
Results:
Multivariate logistic regression analysis demonstrated that each natural log-unit increase in NT-pro-BNP (corresponding to an approximately 2.72-fold increase in NT-pro-BNP concentration) was an independent risk factor for MACE (odds ratio [OR] =1.27), whereas each 0.1 mmol/L increase in serum potassium concentration was independently associated with a lower risk of MACE (OR =0.82). RCS analysis revealed a non-linear inverse association between serum potassium concentration and MACE risk, whereas NT-pro-BNP levels showed a significant positive association with MACE risk. The area under the ROC curve for the combined assessment of serum potassium and NT-pro-BNP was 0.73, which was significantly greater than that of either biomarker alone.
Conclusion:
Hypokalemia and elevated NT-pro-BNP levels are closely associated with an increased short-term risk of MACE in elderly patients with CHF. The combined assessment of these two indicators may provide clinical value for the early identification of high-risk patients.
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