The association of baseline N-terminal pro-B-type natriuretic peptide with short and long-term prognosis following percutaneous coronary intervention in non-ST segment elevation acute coronary syndrome with multivessel coronary artery disease: a retrospective cohort study

Abstract

Background Several studies have shown that N-terminal pro-B-type natriuretic peptide (NT-proBNP) is strongly correlated with the complexity of coronary artery disease and the prognosis of patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS), However, it remains unclear about the prognostic value of NT-proBNP in patients with NSTE-ACS and multivessel coronary artery disease (MCAD) undergoing percutaneous coronary intervention (PCI). Therefore, this study aimed to reveal the relationship between NT-proBNP levels and the prognosis for NSTE-ACS patients with MCAD undergoing successful PCI. Methods This study enrolled 1022 consecutive NSTE-ACS patients with MCAD from January 2010 to December 2014. The information of NT-proBNP levels was available from these patients. The primary outcome was in-hospital all-cause death. In addition, the 3-year follow-up all-cause death was also ascertained. Results A total of 12 (1.2%) deaths were reported during hospitalization. The 4th quartile group of NT-proBNP (>\u20091287\xa0pg/ml) showed the highest in-hospital all-cause death rate (4.3%) ( P \u2009<\u20090.001). Besides, logistic analyses revealed that the increasing NT-proBNP level was robustly associated with an increased risk of in-hospital all-cause death (adjusted odds ratio (OR): 2.86, 95% confidence interval (CI)\u2009=\u20091.16–7.03, P \u2009=\u20090.022). NT-proBNP was able to predict the in-hospital all-cause death (area under the curve (AUC)\u2009=\u20090.888, 95% CI\u2009=\u20090.834–0.941, P \u2009<\u20090.001; cutoff: 1568\xa0pg/ml). Moreover, as revealed by cumulative event analyses, a higher NT-proBNP level was significantly related to a higher long-term all-cause death rate compared with a lower NT-proBNP level ( P \u2009<\u20090.0001). Conclusions The increasing NT-proBNP level is significantly associated with the increased risks of in-hospital and long-term all-cause deaths among NSTE-ACS patients with MCAD undergoing PCI. Typically, NT-proBN P \u2009>\u20091568\xa0pg/ml is related to the all-cause and in-hospital deaths.