Clinical value of combined plasma brain natriuretic peptide and serum cystatin C measurement on the prediction of heart failure in patients after acute myocardial infarction

Liu, Rui; Gao, Changzheng

doi:10.1590/1414-431X2023e12910

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Brazilian Journal of Medical and Biological Research

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Research Article • Braz. J. Med. Biol. Res. 56 • 2023 • https://doi.org/10.1590/1414-431X2023e12910 copy

Clinical value of combined plasma brain natriuretic peptide and serum cystatin C measurement on the prediction of heart failure in patients after acute myocardial infarction

Authorship SCIMAGO INSTITUTIONS RANKINGS

This research investigated the predictive value of combined detection of brain natriuretic peptide (BNP) and cystatin C (Cys C) in heart failure after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Sixty-five AMI patients complicated by heart failure (HF) after PCI and 79 non-heart failure (non-HF) patients were involved in this research. The levels of Cys C and BNP were measured. Risk factors for heart failure in AMI patients after PCI were analyzed by multivariate logistic regression analysis. Efficacy of BNP and Cys C on predicting heart failure were analyzed by receiver operating characteristic (ROC) curve. Cys C and BNP levels were significantly higher in the HF group than in the non-HF group. BNP and Cys C levels were the independent influencing factors causing heart failure within one year after PCI. The area under the predicted curve (AUC) of Cys C, BNP, and combined Cys C and BNP were 0.763, 0.829, and 0.893, respectively. The combined detection of Cys C and BNP was highly valuable in predicting heart failure in AMI patients after PCI, which can be regarded as the serum markers for diagnosis and treatment of heart failure.

Heart failure; Percutaneous coronary intervention; Acute myocardial infarction; Cystatin C; Brain natriuretic peptide

	Non-HF (n=79)	HF (n=65)	P value
Age (years)	59.7±7.8	67.4±8.1	0.039
Body mass index (kg/m²)	23.8±3.3	24.6±2.9	0.198
Male	48 (60.8%)	31 (47.7%)	0.132
Female	31 (39.2%)	34 (52.3%)
Diabetes	18 (22.8%)	20 (30.8%)	0.343
Hypertension	24 (30.4%)	28 (43.1%)	0.121
Hyperlipidemia	21 (26.6%)	23 (35.4%)	0.279
COPD	5 (6.3%)	6 (9.2%)	0.545
Prior stroke	4 (5.1%)	5 (7.7%)	0.732
Chronic kidney disease	12 (15.2%)	15 (23.1%)	0.285
Heart rate (bpm)	75.7±16.2	86.2±17.48	0.016
SBP (mmHg)	129.5±25.6	133.8±27.2	0.368
DBP (mmHg)	86.9±16.4	92.3±18.2	0.235
LVEF (%)	54.1±8.5	41.8±9.2	<0.001
LVEDD (mm)	4.7±1.1	5.0±1.2	0.211
LVEDV (mL)	104.6±23.9	108.9±26.4	0.395
HDL-C (mmol/L)	1.44±0.51	1.28±0.49	0.116
LDL-C (mmol/L)	2.75±0.93	3.13±0.99	0.089
TC (mmol/L)	3.79±1.13	4.28±1.21	0.106
TG (mmol/L)	1.42±0.57	1.81±0.56	0.337
hs-CRP (mg/L)	8.52±3.18	13.61±4.34	<0.001
BNP (pg/mL)	196.81±79.35	309.54±88.93	<0.001
CK-MB (ng/mL)	121.53±49.46	249.94±55.81	<0.001
Cystatin C (mg/L)	1.93±0.68	2.60±0.69	<0.001

	OR	95%CI	P value
High age (years)	1.246	1.101 to 1.314	0.003
High heart rate (bpm)	1.141	1.009 to 1.235	0.015
Low LVEF (%)	3.724	2.748 to 5.104	<0.001
High hs-CRP (mg/L)	1.876	1.552 to 2.095	<0.001
High CK-MB (ng/mL)	2.281	1.916 to 2.779	0.001
High BNP (pg/mL)	1.671	1.381 to 1.974	<0.001
High cystatin C (mg/L)	1.973	1.682 to 2.337	<0.001

	Cut-off value	AUC (95% CI)	P	Sensitivity (%)	Specificity (%)	Youden index
BNP	256.00	0.829 (0.761 to 0.898)	<0.001	75.38	83.54	0.59
Cystatin C	2.29	0.763 (0.685 to 0.840)	<0.001	72.31	70.89	0.43
BNP+Cystatin C⁺	8.08	0.893 (0.842 to 0.945)	<0.001	87.69	82.28	0.70

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[1] Correspondence: Changzheng Gao: <gczxnk123456@163.com>