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Role of N-terminal pro-B-type natriuretic peptide in the prediction of outcomes in ST-elevation myocardial infarction complicated by cardiogenic shock.
- Source :
-
Indian heart journal [Indian Heart J] 2020 Jul - Aug; Vol. 72 (4), pp. 302-305. Date of Electronic Publication: 2020 Jul 12. - Publication Year :
- 2020
-
Abstract
- Although measurements of natriuretic peptides have a role in chronic heart failure and acute coronary syndrome, their role has not been studied in ST-elevation myocardial infarction complicated by cardiogenic shock (CS-STEMI). Sixty-four patients with CS-STEMI were prospectively recruited to assess the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement after 24 h of the onset of angina or anginal equivalent. Patients who died within 24 h were excluded. The mean age was 56.9 ± 10.6 years and the median time to presentation was 22 h (Interquartile range 7-48 h). Thrombolysis was done in 51% and PCI in 31% of cases. The in-hospital mortality was 26.5%. The ROC analysis showed a strong relationship between elevated NT-proBNP and in-hospital mortality (AUC = 0.748; p = 0.003). An NT-proBNP value > 8582 pg/mL showed 76.5% sensitivity, 68% specificity, 46.4% positive predictive value, and 89% negative predictive value for in-hospital mortality. Acute kidney injury [Odds ratio (OR) 7.30; 95% confidence interval (CI) 1.42-37.37] and NT-proBNP (OR 1.12 per 1000 pg/mL; CI 1.012-1.25) were independent predictors of mortality in multivariate regression analysis. Although we found plasma NT-proBNP at 24 h to be an independent predictor of in-hospital mortality in CS-STEMI, additional studies with a larger sample are required to ascertain these findings and validate the appropriate cut-off values.<br />Competing Interests: Declaration of Competing Interest The authors declare that there is no conflict of interest.<br /> (Copyright © 2020 Cardiological Society of India. All rights reserved.)
- Subjects :
- Biomarkers blood
Electrocardiography
Female
Follow-Up Studies
Humans
Incidence
India epidemiology
Male
Middle Aged
Predictive Value of Tests
Prognosis
Prospective Studies
Protein Precursors
ROC Curve
ST Elevation Myocardial Infarction complications
Shock, Cardiogenic epidemiology
Shock, Cardiogenic etiology
Survival Rate trends
Natriuretic Peptide, Brain blood
Peptide Fragments blood
Risk Assessment methods
ST Elevation Myocardial Infarction blood
Shock, Cardiogenic blood
Subjects
Details
- Language :
- English
- ISSN :
- 2213-3763
- Volume :
- 72
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Indian heart journal
- Publication Type :
- Academic Journal
- Accession number :
- 32861389
- Full Text :
- https://doi.org/10.1016/j.ihj.2020.07.002