The Change Of CTnI And NT-proBNP For ACS Patients After PCI And Its Predictive Value Of MACE

Objective(1)This paper discusses the changes of plasma N-terminal ProB-type natriuretic peptide(NT-proBNP) and Cardiac troponin I(cTnI) levels and the relationship with severity ofcoronary artery disease in acute coronary syndrome(ACS) patients with normal cardiacfunction and negative cTnI after Pereutaneous Coronary Intervention (PCI).(2)This paper studies the effects of PCI treatment about plasma cTnI, NT-proBNPlevels and other related indicators in patients with coronary heart disease. And it analyzesthe clinical factors which cause myocardial injury markers elevated after treatment of PCI.(3)This paper discusses the effect of elevated myocardial injury markers in patientswith clinical cardiovascular events and prognosis.(4)This paper discusses the value of joint detection of plasma cTnI and NT-proBNP topredict the main cardiac events and the prognosis of the patients.MethodsSelect106cases of patients receiving PCI and coronary stent implantation with normalpreoperative cTnI/NT–proBNP,male:61,female:10,mean age (57.60±11.3) years.Collectclinical data all of the patients such as blood sugar, blood pressure, total cholesterol,triglycerides, low density lipoprotein cholesterol(LDL-c),electrocardiogram(ECG), echoca-rdiography results, smoking, andfamily history of cardiovascular disease.Do echocardiogra-phy before PCI to ensure that the left ventricular ejection fraction (LVEF)>55%.Specimencollection: in the early morning within24hours in the preoperative and postoperative all ofthe patients on an empty stomach take decubitus elbow venous blood,and determination ofeach patient’s plasma cTnI and NT-proBNP levels.At the same time strict record each indexin the process of operation.Patients must be closely observed the general clinical situationand follow-up of the occurrence of major adverse cardiac events to compare the cTnI andNT-proBNP relationship.This paper also evaluates the relationship between NT-proBNPconcentration and myocardial ischemia, at the same time analyzes intervention operation on myocardial small damage related influencing factors,and the predictive value of combineddetection of cTnI and NT-proBNP ACS patients after PCI in the early and mid-occurrenceof MACE.ResultAfter PCI24hours cTnI and NT-proBNP all rise with significant difference, comparedwith the preoperative.NT-proBNP and cTnI of ACS patients after PCI were positivelycorrelated (r=0.532, P<0.05).This indicates that there is a correlation between cTnI andNT-proBNP, suggesting that NT-proBNP concentration is related to myocardialischemia.Unstable angina, diabetes, bifurcation lesions, multivessel disease, the totalnumber and total time of balloon dilatation have statistically significance between theelevated group and the normal group of cTnI and NT-proBNP.Coronary stent lengthbetween the elevated group and the normal group of cTnI has statistical significance andthere’s no statistical significance between the elevated group and the normal group ofNT-proBNP. Logistic regression analysis shows that the above factors such as unstableangina, diabetes, bifurcation lesions, multivessel disease, the total time and total number ofballoon dilatation are predictors of cTnI and NT-proBNP increased for PCI postoperativepatients. Coronary stent length is the only predictor of elevated cTnI for postoperativepatients.With the seven indicators included in the multiple regression models bySPSS.Multivariate logistic regression analysis shows that the total time of balloonangioplasty, unstable angina, diabetes difference between the two groups has statisticalsignificance(P<0.05), among which diabetes (OR=4.015, P=0.009) is a strong predictor.Aft-er PCI, cTnI elevated group and/or NT-proBNP elevated group of patients with adversecardiovascular events occurred more, the difference has statistical significance. In two kindsof cardiac markers cTnI, NT-proBNP and their test combination cTnI+NT-proBNP,cTnI+NT-proBNP has higher prediction diagnosis efficiency.Conclusions1. Myocardial ischemia is one of the important factor stimulating the NT-proBNPrelease. NT-proBNP level can be used as a prediction index of the severity of acutemyocardial ischemia of coronary lesions.2. Determination of the NT-proBNP to find which heart function is normal, but in highrisk patients can forecast the incidence of MACE after PCI.3. NT-proBNP and cTnI can forecast the incidence of MACE after PCI.Joint detectionof cTnI and NT-proBNP has predictive value of MACE in ACS patients early andmid-term. 4. The factors such as u nstable angina, diabetes, bifurcation lesions, multivesseldisease, the total time and total number of balloon dilatation, coronary stent length can causeelevated level in patients with PCI perioperative myocardial markers level.