Abstract 1037 Acute coronary syndrome: prognostic role of NTproBNP and IGFBP-7

Abstract

Aim: Acute coronary syndrome is a serious illness, which should be treated immediately. But there is a relevant amount of patients who die or suffer a major adverse cardiac event in the months or years following discharge. The goal of the current study is to investigate the prognostic role of NTproBNP and IGFBP-7 to identify potential risk patients.

Methods: The longterm prognostic role of NTproBNP, IGFBP-7 and hsTNT was assessed in a cohort of 185 acute chest pain patients who visited the emergency department at the university hospital of Regensburg. All of them had the diagnosis of acute coronary syndrome, which includes acute ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina and subacute ST elevation myocardial infarction (subacute STEMI). After a median of 55 months, follow-up data regarding the end points all-cause mortality and major adverse cardiac events (MACE: mortality, congestive heart failure, acute coronary syndrome with the necessity of a coronary intervention, and stroke) was collected.

Results: The majority of the cohort was male (76 %) and the median age was 67 years. There were 32 patients who died and 67 patients who suffered from the combined end point during the follow-up. Kaplan-Meier analysis showed that IGFBP-7 and NTproBNP were significant predictors for all-cause mortality and major adverse cardiac events (each p < 0.05), opposite to hsTNT (each p = n.s.). Regarding ROC analysis, the product of NTproBNP x IGFBP-7 showed a significant larger AUC for mortality and MACE (AUC exitus letalis/MACE 0.769/0.687) than NTproBNP (AUC exitus letalis/MACE 0.753/0.671, each p < 0.05). hsTNT had a significant lower AUC than all other markers (AUC exitus letalis/MACE 0.564/0.537, each p < 0.05). According to Cox regression analysis, NTproBNP, IGFBP-7 and the product of NTproBNP x IGFBP-7 were independent predictors for mortality; NTproBNP and IGFBP-7 were independent predictors for the combined end point (each p < 0.05).

Conclusion: In a 55-month follow-up, the predictive value of IGFBP-7 was not inferior to the biochemical gold-standard NTproBNP to identify patients with a high risk of mortality or the combined end point. Thus there was a slightly better trend to predict the end points, there should be further investigations to verify the prognostic role of IGFBP-7 to identify potential risk patients.

Clin Res Cardiol (2023). https://doi.org/10.1007/s00392-023-02180-w
Acute coronary syndrome: prognostic role of NTproBNP and IGFBP-7
I. Haiberger¹, M. Schlossbauer², S. Reynen³, U. Hubauer¹, A. Luchner⁴, L. S. Maier¹, C. G. Jungbauer¹
¹Klinik und Poliklinik für Innere Med. II, Kardiologie, Universitätsklinikum Regensburg, Regensburg; ²Klinik für Anästhesie, Krankenhaus der Barmherzigen Brüder, Regensburg; ³Med. Klinik 2 - Kardiologie, Angiologie, Universitätsklinikum Erlangen, Erlangen; ⁴Klinik für Kardiologie, Krankenhaus Barmherzige Brüder Regensburg, Regensburg;
Abstract Aim: Acute coronary syndrome is a serious illness, which should be treated immediately. But there is a relevant amount of patients who die or suffer a major adverse cardiac event in the months or years following discharge. The goal of the current study is to investigate the prognostic role of NTproBNP and IGFBP-7 to identify potential risk patients. Methods: The longterm prognostic role of NTproBNP, IGFBP-7 and hsTNT was assessed in a cohort of 185 acute chest pain patients who visited the emergency department at the university hospital of Regensburg. All of them had the diagnosis of acute coronary syndrome, which includes acute ST elevation myocardial infarction (STEMI), non-ST elevation myocardial infarction (NSTEMI), unstable angina and subacute ST elevation myocardial infarction (subacute STEMI). After a median of 55 months, follow-up data regarding the end points all-cause mortality and major adverse cardiac events (MACE: mortality, congestive heart failure, acute coronary syndrome with the necessity of a coronary intervention, and stroke) was collected. Results: The majority of the cohort was male (76 %) and the median age was 67 years. There were 32 patients who died and 67 patients who suffered from the combined end point during the follow-up. Kaplan-Meier analysis showed that IGFBP-7 and NTproBNP were significant predictors for all-cause mortality and major adverse cardiac events (each p < 0.05), opposite to hsTNT (each p = n.s.). Regarding ROC analysis, the product of NTproBNP x IGFBP-7 showed a significant larger AUC for mortality and MACE (AUC exitus letalis/MACE 0.769/0.687) than NTproBNP (AUC exitus letalis/MACE 0.753/0.671, each p < 0.05). hsTNT had a significant lower AUC than all other markers (AUC exitus letalis/MACE 0.564/0.537, each p < 0.05). According to Cox regression analysis, NTproBNP, IGFBP-7 and the product of NTproBNP x IGFBP-7 were independent predictors for mortality; NTproBNP and IGFBP-7 were independent predictors for the combined end point (each p < 0.05). Conclusion: In a 55-month follow-up, the predictive value of IGFBP-7 was not inferior to the biochemical gold-standard NTproBNP to identify patients with a high risk of mortality or the combined end point. Thus there was a slightly better trend to predict the end points, there should be further investigations to verify the prognostic role of IGFBP-7 to identify potential risk patients.
https://dgk.org/kongress_programme/jt2023/aP1709.html