{
  "abstract": "Background Biomarkers could improve risk stratification in patients with acute ST-segment elevation myocardial infarction (STEMI), beyond left ventricular ejection fraction (LVEF). Our study evaluated the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP), C reactive protein (CRP) and mortality in a cohort of patients with acute STEMI.Methods This prospective, observational cohort study included patients with reperfused acute STEMI admitted to a tertiary cardiovascular disease centre between July 2020 and October 2023. All patients underwent NT-proBNP and CRP testing. The association between NT-proBNP, CRP and all-cause mortality was evaluated in relation to predischarge LVEF.Results The cohort included 566 patients with a mean age of 63 years. After a median follow-up of 39 months, postdischarge all-cause mortality reached 13.4%. NT-proBNP was associated with mortality irrespective of LVEF (HR 2.34 per SD increment in log NT-proBNP; p<0.001 at LVEF <50% and HR 2.36; p=0.004 at LVEF ≥50%), but the association between CRP and mortality was significant only in patients with LVEF <50% (HR 1.55, p=0.003). Across the cohort, NT-proBNP remained associated with death after adjustment for age, sex, diabetes, baseline high-sensitivity cardiac troponin T (hs-cTnT), CRP, final Thrombolysis in myocardial infarction (TIMI) flow grade and reduced LVEF (HR 1.45, p=0.03). In patients with preserved LVEF, routine NT-proBNP testing (area under the curve (AUC) 0.753 (0.642–0.863), p<0.001) improved risk stratification compared with isolated LVEF assessment (AUC 0.592 (0.453–0.730), p=0.18).Conclusions In a cohort of stabilised acute STEMI survivors, NT-proBNP was associated with all-cause mid-term mortality independent of hs-cTnT and LVEF. The association between CRP and mortality was significant only in patients with LVEF <50%.",
  "authors": [
    {
      "affiliations": [
        "\"Niculae Stancioiu\" Heart Institute, Cluj-Napoca, Romania",
        "Department of Cardiology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania",
        "Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Ioana Mihaela Dregoesc"
    },
    {
      "affiliations": [
        "Department of Heart Disease, Haukeland University Hospital Department of Heart Disease, Bergen, Norway"
      ],
      "name": "Dana Cramariuc"
    },
    {
      "affiliations": [
        "Community Medicine, UiT The Arctic University of Norway, Tromsø, Troms, Norway"
      ],
      "name": "Tom Wilsgaard"
    },
    {
      "affiliations": [
        "\"Niculae Stancioiu\" Heart Institute, Cluj-Napoca, Romania",
        "Department of Cardiology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania"
      ],
      "name": "Mihnea Istrate"
    },
    {
      "affiliations": [
        "\"Niculae Stancioiu\" Heart Institute, Cluj-Napoca, Romania"
      ],
      "name": "Victor Stefan Buiga"
    },
    {
      "affiliations": [
        "\"Niculae Stancioiu\" Heart Institute, Cluj-Napoca, Romania"
      ],
      "name": "Stanca Ichim"
    },
    {
      "affiliations": [
        "\"Niculae Stancioiu\" Heart Institute, Cluj-Napoca, Romania"
      ],
      "name": "Camelia Ober"
    },
    {
      "affiliations": [
        "\"Niculae Stancioiu\" Heart Institute, Cluj-Napoca, Romania",
        "Department of Radiology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania"
      ],
      "name": "Simona Manole"
    },
    {
      "affiliations": [
        "Community Medicine, UiT The Arctic University of Norway, Tromsø, Troms, Norway"
      ],
      "name": "Ekaterina Sharashova"
    },
    {
      "affiliations": [
        "Department of Cardiology, University Hospital of North Norway, Tromsø, Norway"
      ],
      "name": "Michael Stylidis"
    },
    {
      "affiliations": [
        "Massachusetts General Hospital, Boston, Massachusetts, USA"
      ],
      "name": "Judy Hung"
    },
    {
      "affiliations": [
        "\"Niculae Stancioiu\" Heart Institute, Cluj-Napoca, Romania",
        "Department of Cardiology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania"
      ],
      "name": "Adrian Corneliu Iancu"
    },
    {
      "affiliations": [
        "Department of Heart Disease, Haukeland University Hospital Department of Heart Disease, Bergen, Norway"
      ],
      "name": "Øyvind Bleie"
    },
    {
      "affiliations": [
        "Department of Cardiology, University Hospital of North Norway, Tromsø, Norway",
        "Department of Clinical Medicine, UIT The Arctic University of Norway, Tromsø, Norway"
      ],
      "name": "Terje Steigen"
    }
  ],
  "title": "Prognostic value of N-terminal pro-B-type natriuretic peptide and C reactive protein testing in patients with acute ST-segment elevation myocardial infarction",
  "uid": "a08bd747-42b6-541a-9e6d-3aab7f823927"
}