The Prognostic Value of Cardiovascular Risk Factors and Laboratory Biomarker in Predicting 6-Months NSTEMI Outcomes

Introduction

The GRACE score widely used to stratify the risk of major cardiovascular events, after acute coronary syndrome, including non-ST segment elevation myocardial infarction. Predictions based on these scores are often inconsistent and not suitable for all patient populations. Our objective is to examine whether cardiovascular risk factors and certain laboratory biomarkers can predict re-hospitalization in patients with NSTEMI.

Material and Method

A retrospective study, involving 192 adult patients who were admitted into the cardiac intensive care unit (CICU) with NSTEMI, was conducted from April 2016 to April 2018. All patients underwent a therapeutic Percutaneous Coronary Intervention (PCI). Clinical outcomes and blood biomarkers were assessed up to 48 hours prior to PCI and the patients were followed for 6-month. The associations between cardiovascular risk factors, laboratory biomarkers, the frequency of 6 months MACEs and hospitalization were examined.

Results and discussion

In patients with NSTEMI who underwent interventional PCI, hypertension (HTN) was associated positively with a higher frequency of 6-month MACE frequency [β-coefficient=0.15 (CI, 0.07-3.99), p=0.04]. Other clinical outcomes and blood biomarkers such as leukocytes, hemoglobin and BNP, did not significantly predict the frequency of MACEs or hospitalization.

Conclusion

Predicting the risk of a 6-month hospitalization is important for the management of NSTEMI patients. We found that HTN predicted MACE within 6-months of discharge. In addition, risk factors as HTN predicted more frequent MACEs. Whereas BNP showed a trending in predicting hospitalization and frequency of MACE. Further larger studies are required to assess whether BNP may be used to stratify the hospitalization risk for NSTEMI patients.