J Biomed Transl Res.  2017 Sep;18(3):67-74. 10.12729/jbtr.2017.18.3.067.

Prognostic role of NT-proBNP (N-terminal pro-brain natriuretic peptide) in patients with non-ST-segment elevation myocardial infarction: analysis based on propensity score matching and weighting

Affiliations
  • 1Medical Research Institute, School of Medicine, Chungbuk National University, Cheongju 28644, Korea.
  • 2Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju 28644, Korea.
  • 3Department of Nursing, Woosong College, Daejeon 34606, Korea.
  • 4Department of Biomedical Engineering, School of Medicine, Chungbuk National University, Cheongju 28644, Korea. kimka@chungbuk.ac.kr

Abstract

Recently, N-terminal pro-brain natriuretic peptide (NTproBNP) has been widely used in the areas of diagnosis, monitoring treatment efficiency, and prognosis for various heart diseases, especially heart failure (HF). In this paper, we try to estimate the prognostic significance of NT-proBNP as a risk evaluation marker in Non-ST-segment Elevation Myocardial Infarction (NSTEMI) patients. We selected NSTEMI patients who underwent percutaneous coronary intervention (PCI) primarily using a drug-eluting stent within 24 h after the onset of chest pain. We compared incidences of major adverse cardiac events (MACE) including death, myocardial infarction (MI), stent thrombosis (ST), and target vessel revascularization (TVR) in two patient groups according to a high or low serum concentration of NT-proBNP, which was measured in the emergency room (ER). We intend to minimize selection bias selecting comparing groups, considering covariate of observed variables together using propensity score matching (PSM) and propensity score weighting (PSW) based on propensity score (PS) to control the difference in baseline characteristics between high- and low NT-proBNP groups. We found that as the log NT-proBNP value increases by 1 through a hazard function of COX's analysis, the risk of MACE increases by 1.312 times. This result indicated that the NT-proBNP level on ER admission can be used as a significant prognostic indicator to estimate 1 year of MACE in NSTEMI patients who were treated with PCI within 24 h after the onset of chest pain.

Keyword

major adverse cardiac events; myocardial infarction; propensity score matching; propensity score weighting; NT-proBNP
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