The age, NT-proBNP, and Ejection Fraction Score as a Novel Predictor of Clinical Outcomes in CAD Patients After PCI,Clinical and Applied Thrombosis/Hemostasis

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The age, NT-proBNP, and Ejection Fraction Score as a Novel Predictor of Clinical Outcomes in CAD Patients After PCI
Clinical and Applied Thrombosis/Hemostasis ( IF 2.3 ) Pub Date : 2022-07-28 , DOI: 10.1177/10760296221113345
Lei Fan _{1,

2} , Zeng-Lei Zhang _{1,

2} , Jun-Nan Tang _{1,

2} , Qian-Qian Guo _{1,

2} , Jian-Chao Zhang _{1,

2} , Meng-Die Cheng _{1,

2} , Feng-Hua Song _{1,

2} , Zhi-Yu Liu _{1,

2} , Kai Wang _{1,

2} , Li-Zhu Jiang _{1,

2} , Xiao-Ting Yue _{1,

2} , Yan Bai _{1,

2} , Xin-Ya Dai _{1,

2} , Ru-Jie Zheng _{1,

2} , Ying-Ying Zheng _{1,

2,

3} , Jin-Ying Zhang _{1,

2}

Affiliation

Background

Previous evidences have been proved that age, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and ejection fraction are tightly associated with the long-term outcomes in patients suffered from coronary artery disease (CAD). Therefore, the present study aimed to assess the prognosis value of age, NT-proBNP, and ejection fraction (ABEF) score in CAD patients who underwent percutaneous coronary intervention (PCI).

Methods

Observational cohort methodology was used in this study which enrolled totally 3561 patients. And the patients were followed up regularly for 37.59 ± 22.24 months. Patients were classed into three groups based on the tertiles of ABEF sore: first tertile (<5.06, n = 831), second tertile (5.06-6.25, n = 839), and third tertile (≥ 6.25, n = 834). The ABEF score was calculated as follows: age (years)/ejection fraction (%) + NT-proBNP (NT-proBNP<177pg/mL was 1, 177≤NT-proBNP≥524pg/mL was 2 and NT-proBNP > 524pg/mL is 3). The association between ABEF score and adverse prognosis, including all-cause death (ACD), cardiac death (CD), major adverse cardiovascular events (MACEs) and major adverse cardiac and cerebrovascular events (MACCEs), in patients who underwent PCI was analyzed.

Results

According to the risk category of ABEF score, the incidences of ACD (P < .001), CD (P < .001) and MACCEs (P = .021) among the three groups showed significant differences. Multivariate Cox regression analysis suggested that the respective risks of ACD and CD were increased 3.013 folds (hazard risk [HR] = 4.013 [95% confidence interval [CI]: 1.922-8.378], P < .001) and 4.922 folds ([HR] = 5.922 [95% [CI]: 2.253-15.566], P < .001) in the third tertile compared with those in the first tertile. Kaplan-Meier survival analyses showed that the cumulative risks of ACD,CD and MACCEs in patients with the high ABEF score tended to increase.

Conclusion

The present study indicated ABEF score was a novel biomarker suitable for predicting adverse prognosis in patients after PCI, which may be used for early recognition and risk stratification.

中文翻译：

年龄、NT-proBNP 和射血分数评分作为 CAD 患者 PCI 后临床结果的新预测因子

背景

先前的证据已经证明，年龄、N末端B型利钠肽前体（NT-proBNP）和射血分数与冠状动脉疾病（CAD）患者的长期预后密切相关。因此，本研究旨在评估接受经皮冠状动脉介入治疗（PCI）的 CAD 患者的年龄、NT-proBNP 和射血分数（ABEF）评分的预后价值。

方法

本研究采用观察性队列方法，共纳入 3561 名患者。患者定期随访37.59±22.24个月。根据 ABEF 疼痛的三分位数将患者分为三组：第一三分位数（<5.06，n = 831）、第二三分位数（5.06-6.25，n = 839）和第三三分位数（≥ 6.25，n = 834）。ABEF评分计算如下：年龄（岁）/射血分数（%）+NT-proBNP（NT-proBNP<177pg/mL为1，177≤NT-proBNP≥524pg/mL为2，NT-proBNP>524pg /mL 为 3)。分析了接受PCI的患者的ABEF评分与不良预后之间的关系，包括全因死亡（ACD）、心源性死亡（CD）、主要不良心血管事件（MACEs）和主要不良心脑血管事件（MACCEs）。

结果

根据ABEF评分的风险类别，三组间ACD（P <.001）、CD（P <.001）和MACCEs（P =.021）的发生率存在显着差异。多变量 Cox 回归分析表明，ACD 和 CD 各自的风险增加了 3.013 倍（风险风险 [HR] = 4.013 [95% 置信区间 [CI]：1.922-8.378]，P < .001）和 4.922 倍（[HR ] = 5.922 [95% [CI]: 2.253-15.566], P < .001) 在第三个三分位数与第一个三分位数相比。Kaplan-Meier生存分析显示，ABEF评分高的患者ACD、CD和MACCEs的累积风险有增加的趋势。