{"title":"NT-proBNP 对心肌梗死急性期新发心房颤动的预测价值。","authors":"Zhimin Dong, Xiaoxia Hou, Caixia Guo","doi":"","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess the predictive value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels on admission and new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).</p><p><strong>Methods: </strong>In this study, a retrospective cohort study design scheme was used to include a total of 291 consecutive patients who were hospitalized for AMI from July 2019 to May 2020, of whom 36 (12.4%) developed new-onset atrial fibrillation (AF) during their hospitalization, which was classified as the AF group, and the rest of the patients were in the non-AF group. The impact of NT-pro-BNP on new-onset atrial fibrillation was investigated using the general data, laboratory tests, cardiac ultrasonography, and coronary angiography results of the two groups. Logistic regression analysis was employed to investigate the effect of NT-pro-BNP on new-onset atrial fibrillation. Additionally, we analyzed the significance of NT-pro-BNP in predicting new-onset AF in AMI patients using the the area under the AUC.</p><p><strong>Results: </strong>Univariate analysis indicated that patients in the AF group had significantly higher (P < .05) age, leukocyte count on admission, high-sensitivity C-reactive protein (hs-CRP), blood creatinine, uric acid, NT-pro-BNP, and left ventricular end-diastolic internal diameter (LVED) than those in the non-AF group. Patients in the AF group had lower blood pressure and left ventricular ejection fraction compared with the non-AF group. Logistic multifactorial regression analysis indicated that NT-pro-BNP was an independent risk factor for new-onset AF in patients with AMI (OR=2.752, 95% CI 1.352-5.602, P = .005). The area under the AUC was 0.747 (95% CI 0.655-0.84; P = .001), with a sensitivity of 64%, a specificity of 78%, and a Jordon's index of 0.458. This corresponds to an optimal cutoff value of 5374 pg/ml, suggesting that NT-pro-BNP performs well in predicting new-onset atrial fibrillation.</p><p><strong>Conclusion: </strong>NT-pro-BNP on admission can be a useful predictor of whether new-onset atrial fibrillation occurs in patients with AMI, with good predictive value. This finding helps better to meet patients' diagnostic and therapeutic needs and provides useful clinical guidance to improve the management and prognosis of AMI patients.</p>","PeriodicalId":7571,"journal":{"name":"Alternative therapies in health and medicine","volume":" ","pages":"528-532"},"PeriodicalIF":1.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Predictive Value of NT-proBNP for New-onset Atrial Fibrillation in the Acute Phase of Myocardial Infarction.\",\"authors\":\"Zhimin Dong, Xiaoxia Hou, Caixia Guo\",\"doi\":\"\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The objective of this study was to assess the predictive value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels on admission and new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).</p><p><strong>Methods: </strong>In this study, a retrospective cohort study design scheme was used to include a total of 291 consecutive patients who were hospitalized for AMI from July 2019 to May 2020, of whom 36 (12.4%) developed new-onset atrial fibrillation (AF) during their hospitalization, which was classified as the AF group, and the rest of the patients were in the non-AF group. The impact of NT-pro-BNP on new-onset atrial fibrillation was investigated using the general data, laboratory tests, cardiac ultrasonography, and coronary angiography results of the two groups. Logistic regression analysis was employed to investigate the effect of NT-pro-BNP on new-onset atrial fibrillation. Additionally, we analyzed the significance of NT-pro-BNP in predicting new-onset AF in AMI patients using the the area under the AUC.</p><p><strong>Results: </strong>Univariate analysis indicated that patients in the AF group had significantly higher (P < .05) age, leukocyte count on admission, high-sensitivity C-reactive protein (hs-CRP), blood creatinine, uric acid, NT-pro-BNP, and left ventricular end-diastolic internal diameter (LVED) than those in the non-AF group. Patients in the AF group had lower blood pressure and left ventricular ejection fraction compared with the non-AF group. Logistic multifactorial regression analysis indicated that NT-pro-BNP was an independent risk factor for new-onset AF in patients with AMI (OR=2.752, 95% CI 1.352-5.602, P = .005). The area under the AUC was 0.747 (95% CI 0.655-0.84; P = .001), with a sensitivity of 64%, a specificity of 78%, and a Jordon's index of 0.458. This corresponds to an optimal cutoff value of 5374 pg/ml, suggesting that NT-pro-BNP performs well in predicting new-onset atrial fibrillation.</p><p><strong>Conclusion: </strong>NT-pro-BNP on admission can be a useful predictor of whether new-onset atrial fibrillation occurs in patients with AMI, with good predictive value. This finding helps better to meet patients' diagnostic and therapeutic needs and provides useful clinical guidance to improve the management and prognosis of AMI patients.</p>\",\"PeriodicalId\":7571,\"journal\":{\"name\":\"Alternative therapies in health and medicine\",\"volume\":\" \",\"pages\":\"528-532\"},\"PeriodicalIF\":1.9000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Alternative therapies in health and medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"INTEGRATIVE & COMPLEMENTARY MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Alternative therapies in health and medicine","FirstCategoryId":"3","ListUrlMain":"","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"INTEGRATIVE & COMPLEMENTARY MEDICINE","Score":null,"Total":0}
引用次数: 0
摘要
研究目的本研究旨在评估急性心肌梗死（AMI）患者入院时N末端前脑钠尿肽（NT-pro-BNP）水平和新发房颤（AF）的预测价值：本研究采用回顾性队列研究设计方案，共纳入2019年7月至2020年5月期间因AMI住院的连续患者291例，其中36例（12.4%）在住院期间出现新发房颤，被划分为房颤组，其余患者为非房颤组。通过两组患者的一般数据、实验室检查、心脏超声波检查和冠状动脉造影结果，研究了NT-pro-BNP对新发房颤的影响。我们采用逻辑回归分析来研究 NT-pro-BNP 对新发心房颤动的影响。此外，我们还利用AUC下面积分析了NT-pro-BNP在预测急性心肌梗死患者新发房颤方面的意义：单变量分析表明，房颤组患者的年龄、入院时白细胞计数、高敏 C 反应蛋白（hs-CRP）、血肌酐、尿酸、NT-pro-BNP 和左心室舒张末期内径（LVED）均明显高于非房颤组患者（P < .05）。与非房颤组相比，房颤组患者的血压和左心室射血分数较低。逻辑多因素回归分析表明，NT-pro-BNP是AMI患者新发房颤的独立风险因素（OR=2.752，95% CI 1.352-5.602，P = .005）。AUC下面积为0.747（95% CI 0.655-0.84；P = .001），灵敏度为64%，特异度为78%，乔登指数为0.458。这与5374 pg/ml的最佳临界值相对应，表明NT-pro-BNP在预测新发心房颤动方面表现良好：入院时的NT-pro-BNP是预测急性心肌梗死患者是否发生新发心房颤动的有效指标，具有良好的预测价值。这一发现有助于更好地满足患者的诊断和治疗需求，并为改善急性心肌梗死患者的管理和预后提供有用的临床指导。
Predictive Value of NT-proBNP for New-onset Atrial Fibrillation in the Acute Phase of Myocardial Infarction.
Objective: The objective of this study was to assess the predictive value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) levels on admission and new-onset atrial fibrillation (AF) in patients with acute myocardial infarction (AMI).
Methods: In this study, a retrospective cohort study design scheme was used to include a total of 291 consecutive patients who were hospitalized for AMI from July 2019 to May 2020, of whom 36 (12.4%) developed new-onset atrial fibrillation (AF) during their hospitalization, which was classified as the AF group, and the rest of the patients were in the non-AF group. The impact of NT-pro-BNP on new-onset atrial fibrillation was investigated using the general data, laboratory tests, cardiac ultrasonography, and coronary angiography results of the two groups. Logistic regression analysis was employed to investigate the effect of NT-pro-BNP on new-onset atrial fibrillation. Additionally, we analyzed the significance of NT-pro-BNP in predicting new-onset AF in AMI patients using the the area under the AUC.
Results: Univariate analysis indicated that patients in the AF group had significantly higher (P < .05) age, leukocyte count on admission, high-sensitivity C-reactive protein (hs-CRP), blood creatinine, uric acid, NT-pro-BNP, and left ventricular end-diastolic internal diameter (LVED) than those in the non-AF group. Patients in the AF group had lower blood pressure and left ventricular ejection fraction compared with the non-AF group. Logistic multifactorial regression analysis indicated that NT-pro-BNP was an independent risk factor for new-onset AF in patients with AMI (OR=2.752, 95% CI 1.352-5.602, P = .005). The area under the AUC was 0.747 (95% CI 0.655-0.84; P = .001), with a sensitivity of 64%, a specificity of 78%, and a Jordon's index of 0.458. This corresponds to an optimal cutoff value of 5374 pg/ml, suggesting that NT-pro-BNP performs well in predicting new-onset atrial fibrillation.
Conclusion: NT-pro-BNP on admission can be a useful predictor of whether new-onset atrial fibrillation occurs in patients with AMI, with good predictive value. This finding helps better to meet patients' diagnostic and therapeutic needs and provides useful clinical guidance to improve the management and prognosis of AMI patients.
期刊介绍：
Launched in 1995, Alternative Therapies in Health and Medicine has a mission to promote the art and science of integrative medicine and a responsibility to improve public health. We strive to maintain the highest standards of ethical medical journalism independent of special interests that is timely, accurate, and a pleasure to read. We publish original, peer-reviewed scientific articles that provide health care providers with continuing education to promote health, prevent illness, and treat disease. Alternative Therapies in Health and Medicine was the first journal in this field to be indexed in the National Library of Medicine. In 2006, 2007, and 2008, ATHM had the highest impact factor ranking of any independently published peer-reviewed CAM journal in the United States—meaning that its research articles were cited more frequently than any other journal’s in the field.
Alternative Therapies in Health and Medicine does not endorse any particular system or method but promotes the evaluation and appropriate use of all effective therapeutic approaches. Each issue contains a variety of disciplined inquiry methods, from case reports to original scientific research to systematic reviews. The editors encourage the integration of evidence-based emerging therapies with conventional medical practices by licensed health care providers in a way that promotes a comprehensive approach to health care that is focused on wellness, prevention, and healing. Alternative Therapies in Health and Medicine hopes to inform all licensed health care practitioners about developments in fields other than their own and to foster an ongoing debate about the scientific, clinical, historical, legal, political, and cultural issues that affect all of health care.
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