Portal de investigación
NT-proBNP to guide risk stratification after cardiac rehabilitation in patients with ST-segment elevation myocardial infarction
Fecha de publicación:
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Autores de INCLIVA
Participantes ajenos a INCLIVA
- Monmeneu JV
- López-Lereu MP
- Ventura A
- Bayés-Genís A
- Rodríguez-Capitán J
- Jiménez-Navarro M
- Martínez-Dolz L
- Marín F
Grupos y Plataformas de I+D+i
Abstract
Introduction and objectives The use of N-terminal pro-brain natriuretic peptide (NT-proBNP) after ST-segment elevation acute myocardial infarction (STEMI) is unclear. We evaluated its prognostic significance after post-STEMI cardiac rehabilitation. Methods The prognostic significance of NT-proBNP was tested upon completion of cardiac rehabilitation (median, 45 days post-STEMI) in an exploratory group (n = 105 patients with the researchers blinded to NT-proBNP values) and validated in the following 276 patients. Baseline and cardiac imaging variables including cardiovascular magnetic resonance (CMR) parameters were recorded. The primary endpoint was the occurrence of a first major adverse cardiac event (MACE: cardiac death, myocardial infarction, or re-admission for heart failure). Results In the exploratory group, a cut-off value of NT-proBNP >400 pg/mL emerged as a potent MACE predictor (37 % vs.17 %; hazard ratio [HR]: 6.8 [1.5-30.3], p = 0.01). In the study group, during a 203-week median follow-up, 88 (32 %) first MACEs were detected. NT-proBNP >400 pg/mL (n = 168, 61 %) associated with a higher MACE rate (46 % vs. 10 %, HR: 4.6 [2.3-8.9], p < 0.001) and, separately, with more cardiac deaths, myocardial infarctions, and re-admissions for heart failure (p < 0.05 for all comparisons). NT-proBNP improved the multivariate model for MACE prediction (area under the curve 0.81 vs. 0.72, p < 0.001). Conclusions Even after comprehensive adjustment, NT-proBNP emerges as a potent, accessible and inexpensive tool for risk stratification of STEMI patients after completion of rehabilitation programs.
Copyright © 2025. Published by Elsevier B.V.
Datos de la publicación
- ISSN/ISSNe:
- 0953-6205, 1879-0828
- Tipo:
- Article
- Páginas:
- 83-89
- PubMed:
- 40316461
European Journal of Internal Medicine ELSEVIER SCIENCE BV
Citas Recibidas en Web of Science: 1
Documentos
Filiaciones
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Keywords
- St-segment elevation myocardial infarction; N-terminal pro-brain natriuretic peptide; Cardiovascular magnetic resonance; Prognosis; Rehabilitation
Financiación
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Cita
NT-proBNP to guide risk stratification after cardiac rehabilitation in patients with ST-segment elevation myocardial infarction. Pérez N, De Dios E, Gavara J, Ríos C, Marcos V, Merenciano H, Bertolín C et al. European Journal of Internal Medicine. 2025 julio 01. 13783-89. DOI:10.1016/j.ejim.2025.04.027. PMID:40316461.
