Application of N-terminal pro-brain natriuretic peptide con-centration and the Global Registry of Acute Coronary Events risk score to predict major adverse cardiac events in patients with ST-elevation myocardial infarction after PCI

ZHANG Xue-dan; WANG Xi-hui; HU Pei-jing; DU Zhan-kui

摘要：Background Identifying patients with high risk of death after myocardial infarction is a cornerstone of mod-ern cardiovascular health care.The purpose of this study was to explore the predictive ability of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) concentration and global acute coronary event register (GRACE) risk score in the prognosis of ST-segment elevation myocardial infarction(STEMI) patients,to find a better method for early risk stratification and prognosis judgment in the clinical diagnosis and treatment of STEMI patients,and to provide reliable clinical basis for making the best individualized treatment strategies for patients.Methods The fi-nal analysis included 118 confirmed STEMI patients who had received acute percutaneous coronary intervention(PCI).Thirty patients with STEMI were included in the major cardiac adverse events (MACEs) group,and the rest were included in the non-MACEs group.Multivariate Cox regression analysis was used to assess the relation-ship between the risk factors and MACEs.The receiver operator curves (ROC) were used to determine the area under the statistical curve (AUC).The linear correlation analysis confirmed the relationship between NT-pro-BNP concentration and GRACE score.Results After adjustment for sex,history of current smoking,hyperten-sion,diabetes mellitus,cerebral artery disease and coronary artery vessel lesion (single-vessel lesion,2-vessel le-sion,3-vessel lesion),onset time and medication,the multivariate Cox's regression analysis showed that NT-pro-BNP concentration and GRACE score were the independent predictors for MACEs in STEMI patients who re-ceived PCI.Linear regression analysis showed that the level of NT-pro-BNP was positively correlated with GRACE score (r=0.612,P=0.000).The area under the curve (AUC) for GRACE,NT-pro-BNP and their combina-tion were 0.757,0.723 and 0.782,respectively.Conclusions In a one-year follow-up,the concentration of NT-pro-BNP and GRACE score were valuable of prediction for MACEs in STEMI patients who received PCI.In ad-dition,NT-pro-BNP concentration was positively correlated with GRACE score.Additionally,the concentration of NT-pro-BNP could moderately enhance the GRACE score prediction of 1-year MACEs in STEMI patients who received PCI.