Abstract
Objective: To evaluate the value of NT-proBNP in relation to myocardial injury markers and the extent of coronary artery disease, thereby clarifying its role according to myocardial injury phenotype in acute coronary syndrome. Subjects and Methods: A cross-sectional study was conducted on 90 patients with acute coronary syndrome (STEMI, NSTEMI, and unstable angina) admitted to 30-4 Hospital from July 2025 to January 2026. NT-proBNP, high-sensitivity Troponin I, Killip class, left ventricular ejection fraction (LVEF), and coronary angiographic findings (number of diseased vessels and SYNTAX score) were recorded at admission. Group comparisons were performed using the Mann–Whitney or Chi-square test, and correlations were assessed using Spearman’s coefficient. Results: Unstable angina accounted for 60% of the study population. NT-proBNP levels were significantly higher in patients with myocardial infarction compared with unstable angina (p < 0.001). NT-proBNP showed a positive correlation with high-sensitivity Troponin I and an inverse correlation with LVEF (p < 0.001), and increased according to Killip class. Higher NT-proBNP levels were observed in patients with multivessel disease (≥2 vessels) and SYNTAX score ≥23 (p ≤ 0.001), particularly among those with myocardial infarction. Conclusion: NT-proBNP reflects the myocardial injury phenotype in acute coronary syndrome and is associated with the anatomical severity of coronary artery disease, especially in myocardial infarction. A phenotype-oriented use of NT-proBNP may enhance clinical utility and cost-effectiveness when selecting this test in routine practice.
