Acute Coronary Syndrome, Major Adverse Cardiac Events, Non-ST-Segment Elevation Myocardial Infarction (NSTEMI), ST-segment Elevation Myocardial Infarction (STEMI)
Conditions
Keywords
NT-proBNP, MACEs, Acute coronary syndrome, STEMI, NSTEMI
Brief summary
The role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as a cardiac biomarker in predicting short-term major adverse cardiovascular events (MACEs) in patients with Acute coronary syndrome (ACS) has been insufficiently reported and remains poorly understood. Additionally, the relationship between NT-proBNP levels and specific ACS subtypes has not been thoroughly examined. Therefore, our study investigated the predictive value of high-sensitivity cardiac troponin (hs-cTn) and NT-proBNP levels on admission for 6-month MACEs in patients who presented to the emergency department (ED) with ACS and subsequently underwent percutaneous coronary intervention (PCI). Furthermore, we sought to evaluate the association between MACEs and specific ACS subtypes.
Detailed description
In patients diagnosed with Acute coronary syndrome (ACS) based on anamnesis, clinical findings, electrocardiogram (ECG), and/or serum high-sensitivity cardiac troponin (hs-cTn) level in the emergency department (ED), blood samples for serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) value was additionally taken during transfer to the coronary intensive care unit, and left ventricular ejection fraction (LVEF) was calculated by echocardiography before percutaneous coronary intervention (PCI). In addition, demographics (age, sex, and smoking status), comorbidities (hypertension, diabetes mellitus \[DM\] and/or coronary artery disease \[CAD\]), initial complaints and diagnoses, vital signs (systolic blood pressure \[SBP\], heart rate \[HR\], and peripheral capillary oxygen saturation \[SpO2\]), laboratory parameters (serum creatinine, C-reactive protein, and hs-cTn), and ACS subtypes (ST-elevation Myocardial infarction \[STEMI\], non-ST-elevation Myocardial infarction \[NSTEMI\], or unstable angina pectoris \[USAP\]) were obtained during admission. GRACE risk score was calculated for each patient on admission using eight variables, including age, SBP, HR, and serum creatinine. At the end of the 6-month follow-up period, LVEF of surviving patients was assessed by control echocardiography. The short-term MACEs (e.g., nonfatal ischemic stroke, nonfatal myocardial infarction, cardiovascular mortality, or ED admission due to heart failure) were recorded.
Interventions
DIAGNOSTIC_TESTN-terminal pro-B-type natriuretic peptide (NT-proBNP)
In patients diagnosed with Acute coronary syndrome, blood samples for serum NT-proBNP value were taken during transfer to the coronary intensive care unit
DIAGNOSTIC_TESThigh sensitive cardiac troponin T (hs-cTnT)
In patients diagnosed with Acute coronary syndrome, serum high-sensitive cardiac troponin T (hs-cTnT) levels were measured on admission to the Emergency Department.
Sponsors
Haseki Training and Research Hospital
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Inclusion criteria
* Adult patients (≥18 years old) who were admitted to the emergency department with Acute coronary syndrome and underwent percutaneous coronary intervention between September 2023 and February 2024.
Exclusion criteria
* patients younger than 18 years * patients had no vascular lesions detected on percutaneous coronary intervention, * patients had infective or structural cardiac pathologies (myocarditis, pericarditis, hypertrophic or dilated cardiomyopathies) * patients had chronic heart failure with LVEF \<40%, class 3 and 4 in the Killip classification * patients had a diagnosis of malignancy, chronic renal failure, chronic liver failure, and a history of multiple trauma or surgery within the last month
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Predictive ability of NT-proBNP for 6-months MACEs | From admission to 6 months | The investigators assessed the effectiveness of N-terminal pro-B-type natriuretic peptide (NT-proBNP) value at admission in predicting 6-months major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of MACEs in STEMI | From admission to 6 months | The investigators assessed the incidence of major adverse cardiovascular events (MACEs) in patients with ST-elevation myocardial infarction (STEMI). |
| Incidence of MACEs in NSTEMI | From admission to 6 months | The investigators assessed the incidence of major adverse cardiovascular events (MACEs) in patients with non-ST-elevation myocardial infarction (NSTEMI). |
| Incidence of MACEs in USAP | From admission to 6 months | The investigators assessed the incidence of major adverse cardiovascular events (MACEs) in patients with unstable angina pectoris (USAP). |
Countries
Turkey (Türkiye)
Outcome results
None listed