Objective: To explore the predictive value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) on admission on left ventricular ejection fraction (LVEF) and the in-hospital major adverse cardiac and cerebrovascular events (MACCE) in hospitalized patients with unstable angina (UA). Methods: Data of 2 972 consecutive hospitalized patients with UA in Beijing Friendship Hospital from January 2013 to September 2017 were retrospective analyzed. Patients were divided into 4 groups according to the level of NT-proBNP on admission: 733 cases with NT-proBNP lower than 61 ng/L, 749 cases with NT-proBNP between 61 and 133 ng/L, 747 cases with NT-proBNP between 133 and 326 ng/L, and 743 cases with NT-proBNP higher than 326 ng/L. LVEF and in-hospital MACCE were compared among 4 groups and the predictive value of NT-proBNP on admission on LVEF and in-hospital MACCE was determined by multiple logistical regression analysis. Results: LVEF value became lower with increasing on admission NT-proBNP value ((68.4±4.8)%, (68.2±5.2)%, (67.2±6.7)% and (62.6±10.4)%, F=77.98, P<0.01), while in-hospital MACCE was higher with increasing on admission NT-proBNP value (3.4% (25/733), 3.5% (26/749), 5.5% (41/747) and 7.3% (54/743), χ(2)=16.23, P<0.01) in NT-proBNP lower than 61 ng/L, NT-proBNP between 61 and 133 ng/L, NT-proBNP between 133 and 326 ng/L, and NT-proBNP higher than 326 ng/L group. Multiple logistic regression analysis showed that on admission NT-proBNP was an independent predictor for LVEF<50% (Exp(β)=5.875, 95%CI 3.382-10.207, P<0.001), but not predictor for in-hospital MACCE (Exp(β)=0.783, 95%CI 0.400-1.996, P=0.783). Conclusion: The on admission NT-proBNP level is an independent predictor of left ventricular systolic dysfunction (LVEF<50%), but not an independent predictor of total in-hospital MACCE in hospitalized patients with UA.
目的： 探讨入院即刻N末端B型钠尿肽原（NT-proBNP）对不稳定性心绞痛患者左心室射血分数（LVEF）和院内主要不良心脑血管事件（MACCE）的预测价值。 方法： 回顾性连续入选2013年1月至2017年9月于北京友谊医院心内科住院的不稳定性心绞痛患者2 972例，按入院即刻血浆NT-proBNP四分位水平分为4组，即NT-proBNP<61 ng/L组（733例）、61 ng/L≤NT-proBNP<133 ng/L组（749例）、133 ng/L≤NT-proBNP<326 ng/L组（747例）和NT-proBNP≥326 ng/L组（743例）。收集入选者的相关临床资料。比较各组患者LVEF水平和院内MACCE发生情况。采用多因素logistic回归分析NT-proBNP对不稳定性心绞痛患者LVEF和院内MACCE的预测价值。 结果： 随着NT-proBNP水平升高，患者LVEF降低[NT-proBNP<61 ng/L组、61 ng/L≤NT-proBNP<133 ng/L组、133 ng/L≤NT-proBNP<326 ng/L组和NT-proBNP≥326 ng/L组患者LVEF分别为（68.4±4.8）%、（68.2±5.2）%、（67.2±6.7）%和（62.6±10.4）%，F=77.98，P<0.01]。随着NT-proBNP水平升高，院内MACCE发生率升高[NT-proBNP<61 ng/L组、61 ng/L≤NT-proBNP<133 ng/L组、133 ng/L≤NT-proBNP<326 ng/L组和NT-proBNP≥326 ng/L组患者院内MACCE发生率分别为3.4%（25/733）、3.5%（26/749）、5.5%（41/747）和7.3%（54/743），χ(2)=16.23，P<0.01]。多因素logistic回归分析结果显示，NT-proBNP是LVEF<50%的独立预测因子[Exp（β）=5.875，95%CI 3.382~10.207，P<0.001]，但不是院内MACCE的独立预测因子[Exp（β）=0.783，95%CI 0.400~1.996，P=0.783]。 结论： 入院即刻血浆NT-proBNP水平是不稳定性心绞痛患者LVEF的独立预测因子，但不是院内MACCE的独立预测因子。.
Keywords: Angina, unstable; Natriuretic peptide,brain; Prognosis.