Prognostic Value of NT-proBNP for Predicting Adverse Outcomes in Acute Coronary Syndrome Patients with Preserved and Mildly Reduced Ejection Fraction Following Successful PCI

Abstract

Objectives: This study aimed to evaluate the prognostic significance of NT-proBNP in predicting adverse cardiovascular outcomes among patients with Acute Coronary Syndrome (ACS) who exhibit preserved or mildly reduced Left Ventricular Ejection Fraction (LVEF) following successful Percutaneous Coronary Intervention (PCI). Methodology: In this retrospective cohort study, 200 ACS patients were enrolled, including 100 with preserved LVEF (>50%) and 100 with mildly reduced LVEF (41–49%). Baseline NT-proBNP, echocardiographic parameters, demographic characteristics, and cardiovascular risk factors were recorded. Patients were followed for 90 days to monitor outcomes including mortality, recurrent myocardial infarction (MI), arrhythmias, heart failure (HF), and rehospitalization. Statistical analyses included ANOVA, Chi-square testing, logistic regression, and ROC analysis. Results: The mean age of patients was 57.19 ± 9.99 years, with equal gender distribution. The mean NT-proBNP level was 295.35 ± 109.16 pg/mL. NT-proBNP levels significantly differed across quartiles (p = 0.01), and higher baseline levels were associated with increased risk of adverse outcomes. Logistic regression demonstrated that NT-proBNP independently predicted adverse events (OR = 1.02, p = 0.032), while age also contributed significantly (OR = 1.05, p = 0.045). ROC analysis showed an AUC of 0.75, indicating good predictive ability. Adverse outcomes occurred earlier and more frequently among patients with higher NT-proBNP quartiles, despite preserved or mildly reduced LVEF. Conclusion: NT-proBNP serves as a valuable prognostic biomarker for risk stratification in ACS patients with preserved and mildly reduced LVEF following successful PCI. Elevated levels identify patients at higher risk of complications and may improve clinical decision-making in post-PCI management.