title: Plasma N-terminal pro-B-type natriuretic peptide for prediction of death or nonfatal myocardial infarction following percutaneous coronary intervention.
abstract: B-type natriuretic peptide (BNP) and the N-terminus of pro-BNP (NT-pro-BNP) have prognostic value in patients with heart failure and patients with acute coronary syndromes. Little is known about the prognostic value of baseline NT-pro-BNP alone or in combination with C-reactive protein (CRP) for clinical outcome after percutaneous coronary intervention (PCI). Within a single center registry of contemporaneous PCI, we investigated the prognostic value of baseline plasma NT-pro-BNP and CRP concentrations for the prediction of death or nonfatal myocardial infarction (MI) during 12 to 14 months of follow-up. Among 1,172 consecutive patients, the occurrence of death or MI increased significantly with baseline NT-pro-BNP before PCI (first quartile 0 of 294, second quartile 6 of 291 [2.1%], third quartile 4 of 294 [1.4%], fourth quartile 22 of 293 [7.5%)]; p <0.0001). NT-pro-BNP in the top quartile significantly predicted death (odds ratio [OR] 13.37, 95% confidence interval [CI] 4.50 to 40.38, p <0.0001) and was associated with nonfatal MI (OR 2.53, 95% CI 0.77 to 8.34, p = 0.22) An abnormal CRP was significantly associated with death (OR 3.47, 95% CI 1.26 to 9.54, p = 0.019). Stepwise multivariate logistic regression analysis identified age >65 years and NT-pro-BNP as independent significant predictors of death/MI (age OR 3.18, 95% CI 1.32 to 7.67, p = 0.01; NT-pro-BNP OR 4.57, 95% CI 2.07 to 10.10, p = 0.0001). Baseline NT-pro-BNP before PCI provides important, independent prognostic information for the occurrence of death or nonfatal MI during long-term follow-up.
authors.affiliation: Department of Cardiology, Academic Medical Center, University of Amsterdam, The Netherlands. r.j.dewinter@amc.uva.nl
authors.forename: Robbert J
authors.initials: RJ
authors.lastname: de Winter
authors.forename: An
authors.initials: A
authors.lastname: Stroobants
authors.forename: Karel T
authors.initials: KT
authors.lastname: Koch
authors.forename: Mattijs
authors.initials: M
authors.lastname: Bax
authors.forename: Carl E
authors.initials: CE
authors.lastname: Schotborgh
authors.forename: Karla J
authors.initials: KJ
authors.lastname: Mulder
authors.forename: Gerard T
authors.initials: GT
authors.lastname: Sanders
authors.forename: Jan P
authors.initials: JP
authors.lastname: van Straalen
authors.forename: Johan
authors.initials: J
authors.lastname: Fischer
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Jan J
authors.initials: JJ
authors.lastname: Piek
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood*; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality*; D020097:Natriuretic Peptide, Brain; D009419:Nerve Tissue Proteins / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012044:Regression Analysis
chemical_list: D015415:Biomarkers; D009419:Nerve Tissue Proteins; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein