Current partner codePEPTIDESDE
NCT06569511·Not applicable·OBSERVATIONAL

Predictive Value of NT-proBNP on MACEs After Acute Coronary Syndrome

Status

Completed

Phase

Not applicable

Enrollment

241

Locations

1

Results

Not posted

Publications

5

Study summary

What the protocol is testing.

The role of N-terminal pro-B-type natriuretic peptide (NT-proBNP) as a cardiac biomarker in predicting short-term major adverse cardiovascular events (MACEs) in patients with Acute coronary syndrome (ACS) has been insufficiently reported and remains poorly understood. Additionally, the relationship between NT-proBNP levels and specific ACS subtypes has not been thoroughly examined. Therefore, our study investigated the predictive value of high-sensitivity cardiac troponin (hs-cTn) and NT-proBNP levels on admission for 6-month MACEs in patients who presented to the emergency department (ED) with ACS and subsequently underwent percutaneous coronary intervention (PCI). Furthermore, we sought to evaluate the association between MACEs and specific ACS subtypes.

Full detailed description

In patients diagnosed with Acute coronary syndrome (ACS) based on anamnesis, clinical findings, electrocardiogram (ECG), and/or serum high-sensitivity cardiac troponin (hs-cTn) level in the emergency department (ED), blood samples for serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) value was additionally taken during transfer to the coronary intensive care unit, and left ventricular ejection fraction (LVEF) was calculated by echocardiography before percutaneous coronary intervention (PCI). In addition, demographics (age, sex, and smoking status), comorbidities (hypertension, diabetes mellitus \[DM\] and/or coronary artery disease \[CAD\]), initial complaints and diagnoses, vital signs (systolic blood pressure \[SBP\], heart rate \[HR\], and peripheral capillary oxygen saturation \[SpO2\]), laboratory parameters (serum creatinine, C-reactive protein, and hs-cTn), and ACS subtypes (ST-elevation Myocardial infarction \[STEMI\], non-ST-elevation Myocardial infarction \[NSTEMI\], or unstable angina pectoris \[USAP\]) were obtained during admission. GRACE risk score was calculated for each patient on admission using eight variables, including age, SBP, HR, and serum creatinine. At the end of the 6-month follow-up period, LVEF of surviving patients was assessed by control echocardiography. The short-term MACEs (e.g., nonfatal ischemic stroke, nonfatal myocardial infarction, cardiovascular mortality, or ED admission due to heart failure) were recorded.

Interventions

Treatment arms and agents.

DIAGNOSTIC_TEST

N-terminal pro-B-type natriuretic peptide (NT-proBNP)

In patients diagnosed with Acute coronary syndrome, blood samples for serum NT-proBNP value were taken during transfer to the coronary intensive care unit

DIAGNOSTIC_TEST

high sensitive cardiac troponin T (hs-cTnT)

In patients diagnosed with Acute coronary syndrome, serum high-sensitive cardiac troponin T (hs-cTnT) levels were measured on admission to the Emergency Department.

Timeline

From registration to results.

  1. First posted

    Aug 26, 2024

  2. Study start

    Sep 1, 2023

  3. Primary completion

    Feb 1, 2024

  4. Study completion

    Mar 1, 2024

  5. Results posted

    Not reported

  6. Registry updated

    Aug 26, 2024

Outcomes

What the study measures.

Primary outcomes

Predictive ability of NT-proBNP for 6-months MACEs

Time frame · From admission to 6 months

The investigators assessed the effectiveness of N-terminal pro-B-type natriuretic peptide (NT-proBNP) value at admission in predicting 6-months major adverse cardiovascular events (MACEs) in patients with acute coronary syndrome.

Secondary outcomes

Incidence of MACEs in STEMI

Time frame · From admission to 6 months

The investigators assessed the incidence of major adverse cardiovascular events (MACEs) in patients with ST-elevation myocardial infarction (STEMI).

Incidence of MACEs in NSTEMI

Time frame · From admission to 6 months

The investigators assessed the incidence of major adverse cardiovascular events (MACEs) in patients with non-ST-elevation myocardial infarction (NSTEMI).

Incidence of MACEs in USAP

Time frame · From admission to 6 months

The investigators assessed the incidence of major adverse cardiovascular events (MACEs) in patients with unstable angina pectoris (USAP).

Eligibility

Who can take part.

Minimum age
18 Years
Maximum age
Not reported
Sex
ALL
Healthy volunteers
Not reported

Inclusion Criteria: * Adult patients (≥18 years old) who were admitted to the emergency department with Acute coronary syndrome and underwent percutaneous coronary intervention between September 2023 and February 2024. Exclusion Criteria: * patients younger than 18 years * patients had no vascular lesions detected on percutaneous coronary intervention, * patients had infective or structural cardiac pathologies (myocarditis, pericarditis, hypertrophic or dilated cardiomyopathies) * patients had chronic heart failure with LVEF \<40%, class 3 and 4 in the Killip classification * patients had a diagnosis of malignancy, chronic renal failure, chronic liver failure, and a history of multiple trauma or surgery within the last month

Study locations

1 registered sites.

Turkey (Türkiye). Showing up to 24 locations stored in the fast local snapshot.

Haseki Training and Research Hospital

Istanbul, Fatih, Turkey (Türkiye)

Publications

Results and literature.

PMID 33605111Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J Epidemiol Glob Health. 2021 Jun;11(2):169-177. doi: 10.2991/jegh.k.201217.001. Epub 2021 Jan 7.PMID 30249382Velilla Moliner J, Gros Baneres B, Povar Marco J, Santalo Bel M, Ordonez Llanos J, Martin Martin A, Temboury Ruiz F. Diagnostic performance of high sensitive troponin in non-ST elevation acute coronary syndrome. Med Intensiva (Engl Ed). 2020 Mar;44(2):88-95. doi: 10.1016/j.medin.2018.07.014. Epub 2018 Sep 21. English, Spanish.PMID 30916200Castro LT, Santos IS, Goulart AC, Pereira ADC, Staniak HL, Bittencourt MS, Lotufo PA, Bensenor IM. Elevated High-Sensitivity Troponin I in the Stabilized Phase after an Acute Coronary Syndrome Predicts All-Cause and Cardiovascular Mortality in a Highly Admixed Population: A 7-Year Cohort. Arq Bras Cardiol. 2019 Mar;112(3):230-237. doi: 10.5935/abc.20180268. Epub 2019 Jan 7.PMID 27703287Vogiatzis I, Dapcevic I, Datsios A, Koutsambasopoulos K, Gontopoulos A, Grigoriadis S. A Comparison of Prognostic Value of the Levels of ProBNP and Troponin T in Patients with Acute Coronary Syndrome (ACS). Med Arch. 2016 Jul 27;70(4):269-273. doi: 10.5455/medarh.2016.70.269-273.PMID 34765262Qin Z, Du Y, Zhou Q, Lu X, Luo L, Zhang Z, Guo N, Ge L. NT-proBNP and Major Adverse Cardiovascular Events in Patients with ST-Segment Elevation Myocardial Infarction Who Received Primary Percutaneous Coronary Intervention: A Prospective Cohort Study. Cardiol Res Pract. 2021 Nov 2;2021:9943668. doi: 10.1155/2021/9943668. eCollection 2021.

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