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.