Key result
An NT-proBNP level > 898 pg/mL on day 1 after percutaneous coronary intervention predicted high-grade ventricular extrasystole at 12 months with 100% sensitivity and 80% specificity in patients with diabetes and myocardial infarction.
Why the study?
Fatal ventricular arrhythmias often cause adverse outcomes in patients with DM during acute MI and the postinfarction period, necessitating new reliable long-term predictive biomarkers.
Does NT-proBNP level on day 1 after PCI predict ventricular arrhythmias at 12 months in young and middle-aged patients with diabetes and myocardial infarction?
Cohort (n=191)
No
Does NT-proBNP level on day 1 after PCI predict ventricular arrhythmias at 12 months in young and middle-aged patients with diabetes and myocardial infarction?
Effect estimate: AUC 0.8429
NT-proBNP levels > 898 pg/mL on day 1 after PCI reliably predict high-grade ventricular arrhythmias at 12 months in young and middle-aged patients with diabetes and myocardial infarction.
Hypothesis-generating for post-PCI arrhythmia risk stratification in diabetic MI; prospective validation required before clinical adoption.
Fatal ventricular arrhythmias in patients with diabetes mellitus (DM) in the acute stage of myocardial infarction (MI) and postinfarction period often cause adverse outcomes. Therefore, the search for new reliable biomarkers in predicting ventricular arrhythmias in the long term is necessary. AIM: This study aimed to evaluate the value of N-terminal-pro hormone BNP (NT-proBNP) in predicting ventricular arrhythmias in young and middle-aged patients with MI and DM-associated ST-segment elevation. MATERIALS AND METHODS: Seventy-six patients (59 men and 17 women) with DM and MI with ST-segment elevation (aged 3659 years; mean 53 5 years) were examined. Anterior MI was diagnosed in 35 patients, and non-anterior MI was detected in 41 patients. The DM duration was up to 1 year in 16 patients, 15 years in 24, and 512 years in 36. Patients were examined on day 1 after percutaneous coronary intervention (PCI) with implantation of 13 stents in the coronary arteries (CA) and again after 12 months. Holter monitoring, echocardiography, and blood tests for NT-proBNP were performed. RESULTS: After PCI, ventricular extrasystole (VES) of grades IIIV according to Lown and Wolf was detected in 21 of 37 (56.7%) patients with DM. The left ventricular ejection fraction (LVEF) was 42% (27%45%), and the NT-proBNP level was 1127 (7902530) at a rate of up to 125 pg/mL. After 12 months, VES was noted in 9 of 37 (24.3%) patients. The LVEF was 33% (28%35%), and the NT-proBNP level was 938 (4971294) pg/mL. A positive correlation was found between the blood serum level of NT-proBNP on day 1 after PCI and the number of grade IIIV VES 12 months later. At an NT-proBNP level of 898 pg/mL on day 1 after PCI, the sensitivity of this biomarker in predicting high-grade VES 12 months after MI in patients with DM was 100%. CONCLUSIONS: The NT-proBNP level after PCI in patients with DM and MI is a reliable predictor of ventricular arrhythmias over the next 12 months.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2023) conducted a cohort in Myocardial infarction with ST-segment elevation and Diabetes Mellitus (n=191). NT-proBNP biomarker assessment vs. Patients without diabetes mellitus was evaluated on Prediction of high-grade ventricular extrasystole (VES grades III-V) at 12 months (AUC 0.8429). An NT-proBNP level > 898 pg/mL on day 1 after percutaneous coronary intervention predicted high-grade ventricular extrasystole at 12 months with 100% sensitivity and 80% specificity in patients with diabetes and myocardial infarction.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: