Valor Prognóstico do NT-proBNP versus Classificação de Killip em Pacientes com Síndromes Coronarianas Agudas

Souza, Thiago Menezes Barbosa de; Cerqueira, Antônio Maurício S.; Suerdieck, Jessica Gonzalez; Sá, Nicole Cruz de; Sodré, Gabriella S.; Correia, Vitor C. A.; Lacerda, Yasmin F.; Fonseca, Leticia L.; Noya-Rabelo, Márcia; Correia, Luís Cláudio Lemos

doi:10.36660/abc.20180345

Cited by 6 publications

(3 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Coronary stenosis in multilesion areas has been shown to be associated with postinfarction ventricular remodelling 35 . The level of NT‐proBNP is considered to be the most valuable biomarker for diagnosing cardiac systolic dysfunction and heart failure 36 . It is well known that myocardial ischaemia or infarction is associated with elevation of NT‐proBNP levels, reflecting the severity of LV dysfunction 37 .…”

Section: Discussionmentioning

confidence: 99%

“…35 The level of NT-proBNP is considered to be the most valuable biomarker for diagnosing cardiac systolic dysfunction and heart failure. 36 It is well known that myocardial ischaemia or infarction is associated with elevation of NT-proBNP levels, reflecting the severity of LV dysfunction. 37 Furthermore, basal glucose levels and poor glycaemic control, consistent with previous reports, are predictors of adverse LV remodelling and cardiovascular events.…”

mentioning

confidence: 99%

See 1 more Smart Citation

The optimal definition and prediction nomogram for left ventricular remodelling after acute myocardial infarction

Zhang,

Zhu,

Luo

et al. 2023

ESC Heart Failure

View full text Add to dashboard Cite

AimsLeft ventricular (LV) remodelling after acute myocardial infarction (AMI) is associated with heart failure and increased mortality. There was no consensus on the definition of LV remodelling, and the prognostic value of LV remodelling with different definitions has not been compared. We aimed to find the optimal definition and develop a prediction nomogram as well as online calculator that can identify patients at risk of LV remodelling.Methods and resultsThis prospective, observational study included 829 AMI patients undergoing percutaneous coronary intervention from January 2015 to January 2020. Echocardiography was performed within the 48 h of admission and at 6 months after infarction to evaluate LV remodelling, defined as a 20% increase in LV end‐diastolic volume (LVEDV), a 15% increase in LV end‐systolic volume (LVESV), or LV ejection fraction (LVEF) < 50% at 6 months. The impact of LV remodelling on long‐term outcomes was analysed. Lasso regression was performed to screen potential predictors, and multivariable logistic regression analysis was conducted to establish the prediction nomogram. The area under the curve, calibration curve and decision curve analyses were used to determine the discrimination, calibration and clinical usefulness of the remodelling nomogram. The incidences of LV remodelling defined by LVEDV, LVESV and LVEF were 24.85% (n = 206), 28.71% (n = 238) and 14.60% (n = 121), respectively. Multivariable Cox regression models demonstrated that different definitions of LV remodelling were independently associated with the composite endpoint. However, only remodelling defined by LVEF was significantly connected with long‐term mortality (hazard ratio = 2.78, 95% confidence interval 1.41–5.48, P = 0.003). Seven variables were selected to construct the remodelling nomogram, including diastolic blood pressure, heart rate, AMI type, stent length, N‐terminal pro brain natriuretic peptide, troponin I, and glucose. The prediction model had an area under the receiver operating characteristics curve of 0.766. The calibration curve and decision curve analysis indicated consistency and better net benefit in the prediction model.ConclusionsLV remodelling defined by LVEDV, LVESV and LVEF were independent predictors for long‐term mortality or heart failure hospitalization in AMI patients after percutaneous coronary intervention. However, only remodelling defined by LVEF was suitable for predicting all‐cause death. In addition, the nomogram can provide an accurate and effective tool for the prediction of postinfarct remodelling.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

The optimal definition and prediction nomogram for left ventricular remodelling after acute myocardial infarction

Zhang,

Zhu,

Luo

et al. 2023

ESC Heart Failure

View full text Add to dashboard Cite

show abstract

“…4 One Brazilian multicenter study demonstrated that the complete revascularization strategy was associated with a significant reduction in the primary (cardiovascular death, re-infarction, and recurring angina) and secondary (stroke, non-fatal cardiorespiratory failure, greater bleeding, or the need for reintervention) outcomes in the one-year follow-up when compared to the incomplete revascularization strategy. 5 The study based on the Portuguese NRACS involves patients with knowingly poor prognostic markers, as they are anatomically multiarterial 6 and hemodynamically in cardiogenic shock, 7 which justified the high mortality in the study. The results showed no difference between complete revascularization in the procedure index as compared to a group consisting of differed complete or incomplete revascularization in relation to the primary outcome of intrahospital death or re-infarction.…”

mentioning

confidence: 99%

Análise das Estratégias de Revascularização em Doentes com Infarte Agudo do Miocárdio em Choque Cardiogênico – Resultados do Registro Português de Síndromes Coronárias Agudas

Soares¹

2021

Arquivos Brasileiros De Cardiologia

View full text Add to dashboard Cite

NT-proBNP Cut-off Values for Risk Stratification in Acute MI and Comparison with Other Risk Assessment Scores

Tan

Koh

Fong

et al. 2022

J Asian Pac Soc Cardiol

View full text Add to dashboard Cite

Background: N-terminal pro-brain natriuretic peptide (NT-proBNP) provides prognostic information regarding the risk of death, acute heart failure and the development of AF in patients with acute coronary syndrome. While there are established cut-off values for the association between clinical risk assessment scores and in-hospital mortality, there is no clear cut-off value for NT-proBNP to guide risk stratification in patients with acute MI (AMI). Our study sought to evaluate the cut-off values of NT-proBNP in all-cause mortality post AMI and to compare with other available risk assessment scores. Methods: We conducted a multi-centre, prospective, observational study involving 411 patients admitted for AMI. Plasma NT-proBNP was assessed within 24 hours of admission. Results: One-year all-cause mortality occurred in 31 (7.6%) of 411 patients. NT-proBNP ≥404 pg/ml had an area under the curve of 0.66 (95% CI [0.54–0.77]; p=0.004) to predict all-cause mortality at 1 year (sensitivity: 80.6%; specificity: 36.9%; positive predictive value: 9.47%; negative predictive value: 95.89%). Using the Youden index, an NT-proBNP level ≥1,995 pg/ml was an independent predictor of all-cause mortality at 1 year (adjusted HR 2.6; 95% CI [1.3–5.5]; p=0.010), regardless of cardiovascular disease risk factors or revascularisation status. There were no significant differences among the predictive values of NT-proBNP, Thrombolysis in MI risk score, Global Registry of Acute Coronary Events risk score and left ventricular ejection fraction in predicting all-cause mortality at 1 year (p>0.05). Conclusion: NT-proBNP level ≥1,995 pg/ml measured within 24 hours of admission for AMI was associated with higher all-cause mortality at 1 year. Randomised controlled trials are needed to further validate the usefulness of NT-proBNP for risk stratification in patients with AMI.

show abstract

Valor Prognóstico do NT-proBNP versus Classificação de Killip em Pacientes com Síndromes Coronarianas Agudas

Cited by 6 publications

References 16 publications

The optimal definition and prediction nomogram for left ventricular remodelling after acute myocardial infarction

The optimal definition and prediction nomogram for left ventricular remodelling after acute myocardial infarction

Análise das Estratégias de Revascularização em Doentes com Infarte Agudo do Miocárdio em Choque Cardiogênico – Resultados do Registro Português de Síndromes Coronárias Agudas

NT-proBNP Cut-off Values for Risk Stratification in Acute MI and Comparison with Other Risk Assessment Scores

Contact Info

Product

Resources

About