Vol 26, No 6 (2019)
Original articles — Clinical cardiology
Published online: 2018-03-26

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The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic peptide in patients with coronary artery disease

Fei Chen1, Jia-qi Li1, Yuan-Wei-Xiang Ou1, Tian-li Xia1, Fang-yang Huang1, Hua Chai1, Bao-tao Huang1, Qiao Li1, Xiao-bo Pu1, Guo-yong Li1, Yong Peng1, Mao Chen1, De-jia Huang1
Pubmed: 29611168
Cardiol J 2019;26(6):696-703.


Background: The impact of renal function on the prognostic value of N-terminal pro–B-type natriuretic
peptide (NT-proBNP) remains unclear in coronary artery disease (CAD). This study sought to
investigate the value of using NT-proBNP level to predict prognoses of CAD patients with different
estimated glomerular filtration rates (eGFRs).
Methods: A retrospective analysis was conducted from a single registered database. 2087 consecutive
patients with CAD confirmed by coronary angiography were enrolled. The primary endpoint was allcause
Results: The mean follow-up time was 26.4 ± 11.9 months and death events occurred in 197 cases.
The NT-proBNP levels increased with the deterioration of renal function, as well as the optimal cutoff
values based on eGFR stratification to predict endpoint outcome (179.4 pg/mL, 1443.0 pg/mL,
3478.0 pg/mL, for eGFR ≥ 90, 60–90 and < 60 mL/min/1.73 m2, respectively). Compared with the
routine cut-off value or overall optimal one, stratified optimal ones had superior predictive ability for
endpoint in each eGFR group (all with the highest Youden’s J statistics). And the prognostic value became
weaker as eGFR level decreased (eGFR ≥ 90 vs. 60–90 vs. < 60 mL/min/1.73 m2, odds ratio [OR]
7.7; 95% confidence interval [CI] 1.7–33.9 vs. OR 4.8; 95% CI 2.7–8.5 vs. OR 3.0; 95% CI 1.5–6.2).
Conclusions: This study demonstrated that NT-proBNP exhibits different predictive values for prognosis
for CAD patients with different levels of renal function. Among the assessed values, the NT-proBNP
cut-off value determined using renal function improve the accuracy of the prognosis prediction of CAD.
Moreover, lower eGFR is associated with a higher NT-proBNP cut-off value for prognostic prediction.

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