Combination of Amino-Terminal Pro-BNP, Estimated GFR, and High-Sensitivity CRP for Predicting Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients
单位：[1]Internal Medical Department, Medical Health Center, Beijing Friendship Hospital, Capital Medical University,Beijing, China临床科室医保中心首都医科大学附属北京友谊医院[2]Department of Cardiology, Beijing Friendship Hospital, Capital Medical University,Beijing, China临床科室心血管中心心内科首都医科大学附属北京友谊医院[3]Clinical Atherosclerosis Research Laboratory, Division of Cardiology, University of Washington, Seattle, WA
Background-Cardiorenal syndrome type 1 (CRS1) as a complication of acute myocardial infarction can lead to adverse outcomes, and a method for early detection is needed. This study investigated the individual and integrated effectiveness of amino-terminal pro-brain natriuretic peptide (Pro-BNP), estimated glomerular filtration rate (eGFR), and high-sensitivity C-reactive protein (CRP) as predictive factors for CRS1 in patients with acute myocardial infarction. Methods and Results-In a retrospective analysis of 2094 patients with acute myocardial infarction, risk factors for CRS1 were analyzed by logistic regression. Receiver operating characteristic curves were constructed to determine the predictive ability of the biomarkers individually and in combination. Overall, 177 patients (8.45%) developed CRS1 during hospitalization. On multivariable analysis, all 3 biomarkers were independent predictors of CRS1 with odds radios and 95% confidence intervals for a 1-SD change of 1.792 (1.311-2.450) for log(amino-terminal pro-brain natriuretic peptide, 0.424 (0.310-0.576) for estimated glomerular filtration rate, and 1.429 (1.180-1.747) for high-sensitivity C-reactive peptide. After propensity score matching, the biomarkers individually and together significantly predicted CRS1 with areas under the curve of 0.719 for amino-terminal pro-brain natriuretic peptide, 0.843 for estimated glomerular filtration rate, 0.656 for high-sensitivity C-reactive peptide, and 0.863 for the 3-marker panel (all P<0.001). Also, the integrated 3-marker panel performed better than the individual markers (P<0.05). CRS1 risk correlated with the number of biomarkers showing abnormal levels. Abnormal measurements for at least 2 biomarkers indicated a greater risk of CRS1 (odds ratio 36.19, 95% confidence interval 8.534-153.455, P<0.001). Conclusions-The combination of amino-terminal pro-brain natriuretic peptide, estimated glomerular filtration rate, and high-sensitivity C-reactive peptide at presentation may assist in the prediction of CRS1 and corresponding risk stratification in patients with acute myocardial infarction.
第一作者单位：[1]Internal Medical Department, Medical Health Center, Beijing Friendship Hospital, Capital Medical University,Beijing, China
通讯作者：
通讯机构：[1]Internal Medical Department, Medical Health Center, Beijing Friendship Hospital, Capital Medical University,Beijing, China[2]Department of Cardiology, Beijing Friendship Hospital, Capital Medical University,Beijing, China[*1]No. 95, Rd. Yong’an, XiCheng District Beijing, China 100050.
推荐引用方式(GB/T 7714)：
Zhang De-Qiang,Li Hong-Wei,Chen Hai-Ping,et al.Combination of Amino-Terminal Pro-BNP, Estimated GFR, and High-Sensitivity CRP for Predicting Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients[J].JOURNAL of the AMERICAN HEART ASSOCIATION.2018,7(19):doi:10.1161/JAHA.118.009162.
APA：
Zhang, De-Qiang,Li, Hong-Wei,Chen, Hai-Ping,Ma, Qing,Chen, Hui...&Zhao, Xue-Qiao.(2018).Combination of Amino-Terminal Pro-BNP, Estimated GFR, and High-Sensitivity CRP for Predicting Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients.JOURNAL of the AMERICAN HEART ASSOCIATION,7,(19)
MLA：
Zhang, De-Qiang,et al."Combination of Amino-Terminal Pro-BNP, Estimated GFR, and High-Sensitivity CRP for Predicting Cardiorenal Syndrome Type 1 in Acute Myocardial Infarction Patients".JOURNAL of the AMERICAN HEART ASSOCIATION 7..19(2018)
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