The impact of changes in N-terminal pro-B-type natriuretic peptide on the outcome of acute kidney injury in patients with ST-segment elevation myocardial infarction after percutaneous coronary intervention: a retrospective study.

Background

Patients with ST-segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) are at heightened risk of acute kidney injury (AKI). Prior studies have suggested that serum N-terminal pro-B-type natriuretic peptide (NT-proBNP) may be linked to AKI development, proposing it as a potential predictive biomarker.

Aim

This study aimed to evaluate whether changes in NT-proBNP levels are associated with the risk of AKI in STEMI patients.

Methods

This retrospective analysis included 107 STEMI patients who underwent PCI. Patients were stratified into three groups based on the percentage change in NT-proBNP levels: a reduction > 30%, a reduction ≤ 30%, or an increase. The primary endpoints were post-PCI AKI incidence and 180-day mortality. Logistic regression was used to assess the association between NT-proBNP dynamics and AKI risk.

Results

A reduction in NT-proBNP of >30% was independently associated with a reduced risk of postoperative AKI (OR = 0.41, 95% CI 0.17-0.98, p = 0.045). This group also exhibited the favorable survival profile, with the lowest 180-day mortality rate (11/62, 17.7%) compared to the ≤ 30% reduction group (9/27, 33.3%) and the increase group (13/18, 72.2%; p < 0.001 for trend).

Conclusion

Dynamics of NT-proBNP levels are closely associated with the incidence of AKI following PCI in STEMI patients. Specifically, an NT-proBNP reduction of >30% may serve as a robust biomarker for predicting lower post-PCI AKI risk and improved short-term survival.