Background

Studies evaluating the association of blood level of N-terminal pro-brain natriuretic peptide (NT-proBNP) with adverse prognosis have yielded conflicting results in patients with acute myocardial infarction (AMI). This meta-analysis sought to evaluate the prognostic value of blood level of NT-proBNP in patients with AMI.

Methods

Two authors independently searched articles in PubMed and Embase databases up to June 13, 2021. Studies evaluating the association of baseline NT-proBNP level with all-cause mortality or major adverse cardiovascular events (MACEs, including death, new or worsening heart failure, recurrent myocardial infarction, revascularization, stroke, etc.) among AMI patients were selected. Multivariable-adjusted risk ratio (RR) with 95% confidence interval (CI) was pooled by the highest vs. lowest category of NT-proBNP level.

Results

A total of 19 studies enrolling 12,158 AMI patients were identified. When compared highest with the lowest category of NT-proBNP level, the pooled RR was 5.28 (95% CI 2.87–9.73) for in-hospital/30-day death, 2.62 (95% CI 2.04–3.37) for follow-up all-cause mortality, and 2.50 (95% CI 1.91–3.28) for follow-up MACEs, respectively. Subgroup analysis further confirmed the value of NT-proBNP in predicting all-cause mortality and MACEs.

Conclusions

Elevated NT-proBNP level is independently associated with an increased risk of all-cause mortality and MACEs. Determination of blood NT-proBNP level can improve risk stratification of AMI patients.

中文翻译：

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N端脑钠肽前体水平与急性心肌梗死患者不良结局的相关性：荟萃分析

背景

评估 N 端脑钠肽前体 (NT-proBNP) 的血液水平与不良预后的关联的研究在急性心肌梗死 (AMI) 患者中产生了相互矛盾的结果。该荟萃分析旨在评估 NT-proBNP 血液水平对 AMI 患者的预后价值。

方法

两位作者独立检索了 PubMed 和 Embase 数据库中截至 2021 年 6 月 13 日的文章。 AMI 患者中选择了心肌梗死、血运重建、中风等）。具有 95% 置信区间 (CI) 的多变量调整风险比 (RR) 由最高与. NT-proBNP 水平的最低类别。

结果

共确定了 19 项研究，共招募了 12,158 名 AMI 患者。与最高类别的 NT-proBNP 水平相比，住院/30 天死亡的汇总 RR 为 5.28（95% CI 2.87–9.73），所有随访为 2.62（95% CI 2.04–3.37） - 原因死亡率和随访 MACE 分别为 2.50 (95% CI 1.91–3.28)。亚组分析进一步证实了 NT-proBNP 在预测全因死亡率和 MACE 方面的价值。

结论

NT-proBNP 水平升高与全因死亡率和 MACE 风险增加独立相关。测定血液NT-proBNP水平可以改善AMI患者的危险分层。