May 1, 2023ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam)48 citationsOpen Access
View Full PaperPrognostic Importance of NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) Following High-Risk Myocardial Infarction in the PARADISE-MI Trial
Structured PICO
Does NT-proBNP predict cardiovascular death or incident HF in patients with acute MI complicated by left ventricular systolic dysfunction or pulmonary congestion?
P
Population
1129 patients with acute myocardial infarction (MI) complicated by left ventricular systolic dysfunction, pulmonary congestion, or both and ≥1 of 8 risk-augmenting factors. Excluded: prior HF.
I
Intervention
Sacubitril/valsartan 200 mg twice daily initiated within 0.5 to 7 days of an MI
C
Comparator
Ramipril 5 mg twice daily initiated within 0.5 to 7 days of an MI
O
Outcome
Composite of cardiovascular death or incident HF (hospitalization or outpatient symptomatic HF), analyzed as time-to-first eventcomposite
NT-proBNP measured within the first week of a high-risk MI provides prognostic information for incident HF, death, and atherosclerotic events independent of hs-cTnT.
Abstract
BACKGROUND: NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a potent predictor of death and heart failure (HF) across multiple populations. We evaluated the prognostic importance of NT-proBNP in patients with acute myocardial infarction (MI) complicated by left ventricular systolic dysfunction, pulmonary congestion, or both and ≥1 of 8 risk-augmenting factors enrolled in the PARADISE-MI trial (Prospective ARNI vs ACE Inhibitor Trial to Determine Superiority in Reducing Heart Failure Events After Myocardial Infarction). METHODS: Patients were randomized to sacubitril/valsartan 200 mg or ramipril 5 mg twice daily within 0.5 to 7 days of a MI. Patients with prior HF were excluded. NT-proBNP and hs-cTnT (high-sensitivity troponin T) were collected at randomization in a prespecified substudy of 1129 patients. The primary end point of PARADISE-MI was a composite of cardiovascular death or incident HF (hospitalization or outpatient symptomatic HF), analyzed as time-to-first event; additional end points included all-cause death and the composite of fatal or nonfatal MI or stroke. RESULTS: interaction=0.46). CONCLUSIONS: Within the first week of a high-risk MI NT-proBNP is associated with incident HF, death and atherosclerotic events. This prognostic information is independent of hs-cTnT. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT02924727.