Effect of N-terminal pro-B-type natriuretic peptide on clinical prognosis of patients with acute coronary syndrome complicat-ed with renal insufficiency after percutaneous coronary intervention
Objective To investigate the effect of N-terminal pro-B-type natriuretic peptide(NT-proBNP)on the prognosis of patients with acute coronary syndrome(ACS)complicated with renal insufficiency(RI)after percutaneous coronary intervention(PCI).Methods 1 608 patients with ACS combined with RI admitted to General Hospital of Northern Theater Command from March 2016 to March 2019 were selected as the study objects.All patients underwent PCI.The level of NT-proBNP was corrected according to renal function.Patients were divided into T1 group(n=536),T2 group(n=536)and T3 group(n=536)according to the uncorrected NT-proBNP level tripartite,and then divided into T1a group(n=536),T2a group(n=534)and T3a group(n=538)according to the correc-ted NT-proBNP level tripartite.The primary outcome event was all-cause death at 12 months after discharge.The secondary outcome e-vents were ischemic events and cardiac death at 12 months.Results In terms of all-cause death,ischemic events and cardiac death,the risk in T2 and T3 groups was higher than that in T1 group,and the risk in T3 group was higher than that in T2 group,meanwhile,the risk in T2a and T3a groups was higher than that in T1a group,and the risk in T3a group was higher than that in T2a group,with statistical significance(P<0.05).There were significant differences in all-cause death and ischemic events in T1,T2 and T3 groups(Log-rank P<0.001).There were also significant differences in all-cause death and ischemic events in T1a,T2a and T3a groups(Log-rank P<0.001).The areas under receiver operating characteristic curves of NT-proBNP uncorrected and NT-proBNP corrected prediction of all-cause death after PCI in ACS patients with RI were 0.764(95%confidence interval 0.723-0.805)and 0.765(95%confidence in-terval 0.724-0.806),respectively,meanwhile,the areas under receiver operating characteristic curves for predicting ischemic events were 0.735(95%confidence interval 0.689-0.780)and 0.735(95%confidence interval 0.689-0.780),respectively,with no statisti-cal significance(P>0.05).Conclusion Plasma NT-proBNP level can predict all-cause death and ischemic events in ACS patients with RI after PCI,but the corrected NT-proBNP level can not improve the accuracy of prediction.
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