Clinical Significance and Predictive Indicators of NT-proBNP Levels Exceeding the Upper Limit of Detection Ragen in Acute Myocardial In-farction
10.11969/j.issn.1673-548X.2024.07.008
- VernacularTitle:急性心肌梗死时超过检测上限的NT-proBNP的临床意义及其预测指标
- Author:
Jianghong LIU
1
;
Jihong FAN
;
Gang WANG
Author Information
1. 100050 首都医科大学附属北京友谊医院心血管内科
- Keywords:
N-terminal pro-brain natriuretic peptide;
Acute myocardial infarction;
Upper limit of detection;
Prognosis
- From:
Journal of Medical Research
2024;53(7):32-37,21
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the clinical significance and predictive indicators of N-terminal pro-brain natriuretic peptide(NT-proBNP)levels exceeding the upper limit of detection range in acute myocardial infarction(AMI).Methods A total of 669 pa-tients with AMI were enrolled and divided into two groups based on their peak NT-proBNP levels:exceeding the upper limit of detection range group(n=50)and detectable group(n=619).The two groups were matched using propensity score matching(1∶2).The clinical and laboratory indicators,coronary artery features,and in-hospital prognosis were compared,and multivariate Logistic regression analysis was used to explore early predictive indicators of NT-proBNP exceeding the upper limit of detection range.Results The neutrophil-to-lymphocyte ratio(NLR),high-sensitivity C-reactive protein levels,and fibrinogen levels were higher in the group with NT-proBNP levels exceeding the upper limit of detection range.These findings were consistent after propensity score matching.In terms of in-hospital prognosis,patients in the group with NT-proBNP levels exceeding the upper limit of detection range had a higher propor-tion of Killip class 2 or higher,longer hospital stays,lower left ventricular ejection fraction,and higher incidence of major adverse cardio-vascular and cerebrovascular events.These findings remained consistent after propensity score matching,but there was no statistically sig-nificant difference in peak myocardial enzyme levels between the two groups before and after propensity score matching.Multivariate Logis-tic regression analysis showed that early predictive indicators of NT-proBNP exceeding the upper limit of detection range included higher NLR,lower use of antiplatelet drugs,high fibrinogen levels,left anterior descending branch occlusion,and older age.After propensity score matching,the predictive indicators of NT-proBNP exceeding the upper limit of detection range were right coronary artery occlusion,high NLR,high fibrinogen levels,and left anterior descending branch occlusion.Conclusion AMI patients with NT-proBNP levels ex-ceeding the upper limit of detection range have poorer in-hospital prognosis.NLR and fibrinogen levels on admission can serve as early predictive indicators of NT-proBNP levels exceeding the upper limit of detection range.
