The predictive value of HEART score combined with NT-proBNP for cardiovascular adverse events in patients with non-ST-elevation acute coronary syndrome / 中华急诊医学杂志

ABSTRACT

Objective:To explore the predictive value of HEART score combined with N-terminal pro-B-type natriuretic peptides (NT-proBNP) for 3-month major adverse cardiovascular events (MACE) in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS).Methods:This was a retrospective cohort study. Adult patients with acute chest pain who met the diagnostic criteria for NSTE-ACS in the 5th Affiliated Hospital of Sun Yat-Sen University from January 2018 to March 2018 were enrolled. Patients with cardiac chest pain caused by diseases other than NSTE-ACS, non-cardiac chest pain, renal insufficiency, acute cerebral infarction, end-stage disease, pregnant, and incomplete data were excluded. Data of all patients’ general clinical information, first electrocardiogram (ECG), cardiac troponin I (cTnI), and NT-proBNP were collected. The correlation between NT-proBNP level and the occurrence of MACE within 3 months was analyzed. The receiver operating characteristic (ROC) curves was drawn, and the predictive value of NT-proBNP, HEART score, and their combination for 3- month MACE in patients with NSTE-ACS were evaluated.Results:A total of 151 patients were enrolled. Patients with NSTE-ACS were divided into the MACE group ( n=95) and non-MACE group ( n=56) according to whether MACE occurred within 3 months of onset. The level of NT-proBNP, the HEART score, and the cTnI level in the MACE group were significantly higher than those in the non-MACE group (all P<0.001). After risk stratification assessed by HEART score in all patients with NSTE-ACS, it was found that the level of NT-proBNP and the incidence of MACE increased as the risk score increased (all P<0.05). The area under the ROC curve of HEART score, NT-proBNP and their combination were 0.819 (95% CI0.751-0.887), 0.821 (95% CI0.752-0.889) and 0.858 (95% CI0.796-0.919), respectively. Conclusions:The combination of HEART score and NT-proBNP level can improve the predictive value for 3-month MACE in patients within NSTE-ACS, and provide important information for treatment decision and improving prognosis.