Prognostic Value of N-Terminal pro-B-Type Natriuretic Peptide in Patients With Acute Coronary Syndromes Undergoing Left Main Percutaneous Coronary Intervention

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概要

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• Background: Patients undergoing acute left main (LM) coronary artery revascularization have a high mortality and natriuretic peptides such as N-terminal pro-B-type (NT-proBNP) have been shown to have prognostic value in patients with acute coronary syndromes. The present study looked at the prognostic value of NT-proBNP in these patients. Methods and Results: We studied all consecutive patients undergoing acute LM coronary artery percutaneous coronary intervention between January 2005 and December 2008 in whom NT-proBNP was measured (n=71). We analyzed the clinical characteristics and the short- and long-term outcomes in relation to NT-proBNP level at admission. Median NT-proBNP was 1,364ng/L, ranging from 46 to 70,000ng/L. NT-proBNP was elevated in 63 (89%) patients and was ≥1,000ng/L in 42 (59%). Log NT-proBNP (hazard ratio [HR] 3.51, 95% confidence interval [CI] 1.55-7.97, P=0.003) and left ventricular ejection fraction (HR 0.95, 95%CI 0.91-0.99, P=0.007) were predictors for all-cause mortality. Log NT-proBNP was the only independent significant predictor of cardiovascular mortality. In-hospital mortality was 0% for patients with NT-proBNP <1,000, but 17% for those with NT-proBNP ≥1,000 (P=0.036). Conclusions: NT-proBNP is a strong predictor of outcome in patients undergoing acute LM coronary artery stenting. Mortality in such patients is high, but those with NT-proBNP <1,000ng/L may have a favorable short- and long-term prognosis. Further research, including a larger patient population, is needed to determine the optimal cut-off value for NT-proBNP in patients undergoing acute LM coronary artery intervention. (Circ J 2011; 75: 2648-2653)

• 社団法人　日本循環器学会の論文
• 2011-10-25

著者

• Luscher Thomas

  Cardiovascular Research Physiology Institute University Of Zurich

• Toggweiler Stefan

  Cardiovascular Center Cardiology University Hospital Zurich

• JABERG Laurenz

  Cardiovascular Center Cardiology, University Hospital Zurich

• PUCK Marietta

  Cardiovascular Center Cardiology, University Hospital Zurich

• FRANK Michelle

  Cardiovascular Center Cardiology, University Hospital Zurich

• RUFIBACH Kaspar

  Biostatistics Unit, Institute for Social and Preventive Medicine, University of Zurich

• CORTI Roberto

  Cardiovascular Center Cardiology, University Hospital Zurich

• Corti Roberto

  Cardiovascular Center Cardiology University Hospital Zurich

• Frank Michelle

  Cardiovascular Center Cardiology University Hospital Zurich

• Rufibach Kaspar

  Biostatistics Unit Institute For Social And Preventive Medicine University Of Zurich

• Luscher Thomas

  Cardiovascular Center Cardiology University Hospital Zurich

• Jaberg Laurenz

  Cardiovascular Center Cardiology University Hospital Zurich

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• Prognostic Value of N-Terminal pro-B-Type Natriuretic Peptide in Patients With Acute Coronary Syndromes Undergoing Left Main Percutaneous Coronary Intervention
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