Osong Public Health Res Perspect.  2017 Aug;8(4):237-246. 10.24171/j.phrp.2017.8.4.02.

Biomarker for the Prediction of Major Adverse Cardiac Events in Patients with Non-ST-Segment Elevation Myocardial Infarction

Affiliations
  • 1Medical Research Institute, College of Medicine, Chungbuk National University, Cheongju, Korea.
  • 2Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea. jangwhan.bae69.gmail.com
  • 3Department of Nursing, Woosong College, Daejeon, Korea.
  • 4Department of Biomedical Engineering, College of Medicine, Chungbuk National University, Cheongju, Korea. kimka@cbnu.ac.kr

Abstract

N-terminal pro-brain natriuretic peptide (NT-proBNP) is a well-known biomarker for the diagnosis and prognosis of heart failure, and is directly associated with myocardial dysfunction. We evaluated the prognostic value of NT-proBNP for major adverse cardiac events (MACEs) among patients with non-ST-segment elevation myocardial infarction (NSTEMI) from the Korea Acute Myocardial Infarction Registry during their mid-term follow-up period. In this paper, we analyzed NT-proBNP according to various MACE and level of NT-proBNP. We used multivariate logistic regression to determine the risk factors according to MACE type and NT-proBNP levels, and to identify the cutoff value for each MACE by using the receiver operating characteristic (ROC) curve. NT-proBNP was a significant variable among cardiac deaths (p = 0.016), myocardial infarction (p = 0.000), and coronary artery bypass grafting (CABG) (p = 0.000) in patients with MACE compared with those without MACE. Two-vessel coronary artery disease (CAD) (p = 0.037) and the maximum creatinine kinase (max-CK) (p = 0.031) produced significant results in repeat percutaneous coronary intervention. The area under the ROC curve was found to be statistically significant for cardiac death and CABG. NT-proBNP is a useful predictor for 12-month MACEs among patients with NSTEMI and in those with heart failure. We propose that a new index incorporating NT-proBNP, max-CK, and CAD vessel will be useful as a prognostic indicator of MACEs in the future.

Keyword

heart disease; cardiac biomarker; myocardial infarction; NT-proBNP
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