Value of plasma NT-proBNP for diagnosing heart failure in patients with previous myocardial infarction
10.3760/cma.j.issn.0253-3758.2012.01.008
- VernacularTitle:N末端B型利钠肽原在陈旧性心肌梗死患者中诊断心力衰竭的价值
- Author:
Bing-Qi WEI
1
;
Jian ZHANG
;
Yue-Jin YANG
;
Rong LU
;
Yu-Hui ZHANG
;
Qiong ZHOU
;
Run-Lin GAO
Author Information
1. 中国医学科学院北京协和医学院阜外心血管病医院
- Keywords:
Myocardial infarction;
Heart failure,congestive;
Natriuretic peptide,brain;
Diagnosis
- From:
Chinese Journal of Cardiology
2012;40(1):34-38
- CountryChina
- Language:Chinese
-
Abstract:
Objective The study aimed to evaluate the value of plasma NT-proBNP in diagnosing heart failure in patients with previous myocardial infarction.Methods Plasma concentration of NT-proBNP was measured in patients with previous myocardial infarction by ELISA method at admission.Patients were divided into non heart failure group(NYHA class I)and heart failure group(NYHA class Ⅱ-Ⅳ).The NT-proBNP levels were compared between NYHA class Ⅰ,Ⅱ,Ⅲ and Ⅳ,and between heart failure group and non heart failure grou.ROC analyses were performed to evaluate the diagnosing value of plasma NT-proBNP for heart failure and to identify the optimal cut-off point for diagnosing heart failure patients.Results Total 586 patients[aged from 25-83(58 ± 11)years,80％ male]with previous myocardial inffarction were enrolled in his study(n =374 of NYHA class Ⅰ,n =99 of NYHA classes Ⅱ,n =82 of NYHA class]Ⅲ,n =31 of NYHA class Ⅳ).Plasma NT-proBNP levels in these four NYHA classes were 484.7(381.6,647.8)pmol/L,907.6(516.6,1290.3)pmol/L,1420.2(879.5,2336.2)pmol/L,2442.6(1695.4,3670.7)pmol/L,respectively(P ＜0.01).The plasma NT-proBNP level in heart failure group wassignificantly higher than in non heart failure group[1148.2(707.9,2145.3)pmol/L vs.484.7(381.6,647.8)pmol/L,P ＜0.01].Plasma NT-proBNP level in patients with age≥60 years was significantly higher than patients with age ＜ 60 years[702.3(472.4,1208.5)pmol/L vs.526.6(392.1,855.6)pmol/L,P＜0.01].ROC analysis showed that the area under the curve(AUC)for diagnosing heart failure was 0.844(95％ CI: 0.809-0.880,P ＜ 0.0l),the optimal plasma NT-proBNP cut-off point for diagnosing heart failure was 700 pmol/L with a sensitivity of 75.9％,a specificity of 79.9％,an accuracy of 78.3％,a positive predictive value of 67.9％ and a negative predictive value of 85.3％.The optimal plasma NT proBNP cut-off point was 600 pmol/L for patients ≥60 years old and 800 pmol/L for patients ＜ 60 years old.Conclusion Plasma NT-proBNP level is a valuable parameter for diagnosing hemt failure in patients with previous myocardial infarction.
