氨基末端脑钠肽前体与非ST段抬高型急性冠状动脉综合征合并多支血管病变接受PCI治疗患者长期预后的关系  

Association of N-terminal pro-B-type natriuretic peptide and long-term prognosis in non-STsegment el⁃evation acute coronary syndrome patients with multivessel coronary artery diseaseundergoing percutane⁃ous coronary intervention

作　　者：何文飞 刘远辉 陈鹏远 曾莉欢 何鹏程 郭志强 HE Wen-fei;LIU Yuan-hui;CHEN Peng-yuan;ZENG Li-huan;HE Peng-cheng;GUO Zhi-qiang(Department of Cardiology,Guangdong Provincial People′s Hospital′s Nanhai Hospital,the Second People′s Hospital of Nanhai District,Foshan,Guangdong 528000,China;Department of Cardiology,Guangdong Pro-vincial People′s Hospital,Guandong Academy of Medical Sciences,Guangzhou 510100,China;School of Med-icine,Southern Medical University,Guangzhou 510100,China)

机构地区：[1]广东省人民医院南海医院(佛山市南海区第二人民医院)心血管内科,广东佛山528000 [2]广东省人民医院(广东省医学科学院)心血管内科,广州510100 [3]南方医科大学,广州510100

出　　处：《岭南心血管病杂志》2020年第6期648-653,共6页South China Journal of Cardiovascular Diseases

摘　　要：目的探讨血浆氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)浓度与非ST段抬高型急性冠状动脉综合征(non-ST-segment elevation acute coronary syndrome,NSTE-ACS)合并多支血管病变成功接受经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗患者长期预后的关系。方法 2010年1月至2014年12月期间,本研究连续入组了1 022例符合标准的患者,入院时均检测了NT-proBNP浓度,跟踪随访3年,记录全因死亡事件。结果在3年随访期间,共发生121例(11.8%)全因死亡。多因素回归分析结果表明,NT-proBNP浓度的增加与3年全因死亡的风险密切相关(OR=1.09,95%CI:1.06~1.13,P<0.001)。NT-proBNP对于3年的全因死亡具有较好的预测意义(曲线下面积=0.797,95%CI:0.749~0.844;最佳阈值:1 305 pg/mL)。结论 NT-proBNP浓度的升高与NSTE-ACS合并多支血管病变接受PCI治疗患者的全因病死率升高相关,而NT-proBNP浓度>1 305 pg/mL可作为预测此类患者3年全因死亡的阈值。Objectives To explore the association between baseline plasma concentration of N-terminal pro-B-type natriuretic peptide(NT-proBNP)and prognosis in non-ST segment elevation acute coronary syndrome(NSTE-ACS)patients with multivessel coronary artery disease(MCAD)received percutaneous coronary intervention(PCI).Methods From January 2010 to December 2014,1022 patients were recruited,and plasma concentration of NT-proBNP in whom was detected at admission.The primary outcome was the 3-year all-cause death.Results During the three-year follow-up,121(11.8%)all-cause deaths occurred.Logistic analysis showed that elevated plasma concentration of NTproBNP closely related to a higher risk of the 3-year all-cause death(OR=1.09,95%CI:1.06-1.13,P<0.001).NTproBNP had a good predictive value on the 3-year all-cause death(area under the curve=0.797,95%CI:0.749-0.844,cutoff:1305 pg/mL).Conclusions Increased plasma concentration of NT-proBNP in NSTE-ACS patients with MCAD receiving PCI clearly associate with a high risk of all-cause death.Concentration of NT-proBNP>1305 pg/mL can be used as a new threshold to predict 3-year all-cause death.

关 键 词：氨基末端脑钠肽前体 非ST段抬高型急性冠状动脉综合征 多支血管病变 

分 类 号：R541.4[医药卫生—心血管疾病]