Prognostic value of brain natriuretic peptide in ST-elevation myocardial infarction patients: A Portuguese registry

Inês Almeida; Joana Chin; Hélder Santos; Hugo Miranda; Mariana Santos; Catarina Sá; Samuel Almeida; Catarina Sousa; Lurdes Almeida; National Cardiology Data Collection Center, Portuguese Society of Cardiology, Coimbra, Portugal, National Register of Acute Coronary Syndromes Investigators

doi:10.1016/j.repc.2020.12.016

Prognostic value of brain natriuretic peptide in ST-elevation myocardial infarction patients: A Portuguese registry

Rev Port Cardiol. 2022 Feb;41(2):87-95. doi: 10.1016/j.repc.2020.12.016. Epub 2021 Dec 8.

[Article in English, Portuguese]

Authors

Inês Almeida¹, Joana Chin², Hélder Santos², Hugo Miranda², Mariana Santos², Catarina Sá², Samuel Almeida², Catarina Sousa³, Lurdes Almeida²; National Cardiology Data Collection Center, Portuguese Society of Cardiology, Coimbra, Portugal, National Register of Acute Coronary Syndromes Investigators

Affiliations

¹ Serviço de Cardiologia, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal. Electronic address: inesalmeida91@gmail.com.
² Serviço de Cardiologia, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal.
³ Serviço de Cardiologia, Centro Hospitalar Barreiro-Montijo, Barreiro, Portugal; Centro Cardiovascular de Universidade de Lisboa, Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.

PMID: 36062710
DOI: 10.1016/j.repc.2020.12.016

Abstract

Introduction: Brain natriuretic peptide (BNP) is a highly sensitive and specific biomarker for the extent of myocardial infarction that is strongly related to short- and long-term prognosis in patients with acute coronary syndromes.

Objective: To assess the prognostic value of BNP levels in a Portuguese cohort of ST-elevation myocardial infarction (STEMI) patients.

Methods: We performed a retrospective analysis of patients admitted with STEMI included in the Portuguese Registry of Acute Coronary Syndromes (ProACS) between 2010 and 2019. Patients were divided into three groups according to BNP level (<100 pg/ml, 100-399 pg/ml and ≥400 pg/ml) and compared. Independent predictors of a composite of all-cause mortality and rehospitalization for cardiovascular causes were assessed by multivariate logistic regression. For sample homogenization, propensity score matching and pairwise matching with a tolerance level of 0.005 were performed.

Results: A total of 1650 patients were included, of whom 21.5% presented high BNP levels (≥400 pg/ml). These were older and had more comorbidities, lower admission systolic blood pressure and hemoglobin, higher heart rate, Killip class and creatinine, worse left ventricular systolic function and severe coronary anatomy. Higher BNP was associated with more in-hospital complications, in-hospital mortality and adverse outcomes at one year.

Conclusion: BNP levels during the index hospitalization were a powerful prognostic biomarker for all-cause mortality and major adverse cardiac events in patients admitted with STEMI to Portuguese hospitals.

Keywords: BNP; Brain natriuretic peptide; Enfarte do miocárdio; Mortalidade; Mortality; Myocardial infarction; Prognosis; Prognóstico; SCA com supradesnivelamento ST; ST-elevation myocardial infarction.