Dynamic biomarker assessment, particularly serial measurement of NT-proBNP, provided enhanced prognostic discrimination over static baseline measurements in patients undergoing percutaneous coronary intervention.
Systematic Review (n=25,833)
Does dynamic cardiac biomarker assessment improve prognostic stratification compared to single baseline measurements in patients undergoing PCI?
Dynamic biomarker assessment, particularly serial NT-proBNP, may offer incremental prognostic value over static baseline measurements in patients undergoing PCI.
Cardiac biomarkers are widely used for risk stratification in patients undergoing percutaneous coronary intervention (PCI), yet their optimal mode of assessment remains uncertain. This systematic review evaluates the prognostic significance of serial, delta, and peak periprocedural cardiac biomarker measurements compared with single baseline measurements. A comprehensive literature search of PubMed/MEDLINE, Scopus, and Web of Science identified nine cohort studies encompassing diverse PCI settings, including elective, primary, and chronic total occlusion interventions. Biomarkers assessed included high-sensitivity and conventional troponin, N-terminal pro-B-type natriuretic peptide (NT-proBNP), and creatine kinase-myocardial band (CK-MB), with varying measurement strategies such as baseline, peak, serial, and delta assessments. The findings demonstrate that baseline troponin levels consistently predict outcomes, whereas post-procedural elevations show variable and threshold-dependent prognostic value. In contrast, serial assessment of NT-proBNP appears to enhance prognostic discrimination and reflects underlying pathophysiologic processes such as ischemic burden and reperfusion dynamics. Considerable heterogeneity was observed in biomarker timing, thresholds, and outcome definitions, precluding quantitative synthesis. Overall, the evidence suggests that dynamic biomarker assessment, particularly for natriuretic peptides, may offer incremental value over static measurements, although its clinical integration requires further validation. These findings support a more nuanced, context-dependent approach to biomarker interpretation in PCI populations.
Anika et al. (Sun,) conducted a systematic review in Percutaneous coronary intervention (n=25,833). Dynamic cardiac biomarker assessment (serial, delta, peak) vs. Single baseline biomarker measurement was evaluated on Prognostic significance (mortality, MACE, reperfusion, remodeling). Dynamic biomarker assessment, particularly serial measurement of NT-proBNP, provided enhanced prognostic discrimination over static baseline measurements in patients undergoing percutaneous coronary intervention.