The prognostic value of the biomarker complex in assessing the outcomes of acute coronary syndrome up to 12 months

Introduction. Highly sensitive tests to determine the level of cardiac troponin in the blood are currently recommended and have a number of advantages. For the purpose of timely diagnosis and identifi cation of patients with a high risk of adverse outcomes of acute coronary syndrome, attempts are made to take a comprehensive approach using several biological markers.

The purpose of the study. To study the prognostic signifi cance of the determination of highly sensitive troponin (highly sensitive cardiac troponin — hs-cTn) in the complex with natriuretic peptide (NT-proBNP) in assessing the outcomes of acute coronary syndrome (ACS).

Material and methods. The analysis of the possibility of using a complex of biological markers in patients with ACS (n = 120), urgently hospitalized in the State Budgetary Institution of Health Nizhny Novgorod region «Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko. Comparison Group for Existing Patients IHD (n = 37), hospitalized in the cardiology department of the State Budgetary Institution of Health Nizhny Novgorod region «Nizhny Novgorod Regional Clinical Hospital named after N.A. Semashko». Observation period showed 42–72 months (from February 2014 to August 2016). Patients underwent a general clinical examination, determination of the level of troponin I (cTnI), hs-cTnI, NT-proBNP, electrocardiogram (ECG), echocardiography, coronary angiography. Using statistical analysis, the prognostic value of the complex of biological markers in ACS was evaluated. The analysis of the obtained material was carried out using the application programs IBM SPSS Statistics for Mac, version 26.0 (IBM Corporation, www.ibm.com (2019), Microsoft Offi ce Excel for Mac (2016), Prism 8 for macOS, version 8.4.2 (464), April 7, 2020 (1994–2020 GraphPad Software, LLC).

Results. A prognostic model of the immediate outcomes of ACS (hospital and up to 12 months) was constructed, which includes the concentration of hs-cTnI (quantitative), the value of NT-proBNP (qualitative), ST segment elevation, and multi-vessel lesion, hyperglycemia. It is shown that the value of the integral index «PROGNOSIS FOR ACS+5» ≥ 0.5926 is associated with a high risk of poor prognosis in ACS for 12 months, and the index value < 0.5926 indicates a low risk of an adverse forecast.

Conclusion. The results of the study indicate the high importance of the prognostic model in assessing the outcomes of acute coronary syndrome (ACS) for 12 months.

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