Perioperative medicine & outcomes
Clinical value of N-terminus pro-brain natriuretic peptide (NT-proBNP), myeloperoxidase (MPO), and neutrophil lymphocyte ratio (NLR) combined with echocardiography in prediction of malignant arrhythmia in elderly patients with valvular heart disease
Authors' conclusion
The combination of NT-proBNP, MPO, NLR, and echocardiography has a predictive value in detecting MA in elderly VHD patients.
Study context
- Population
- Elderly patients with valvular heart disease (VHD)
- Comparison
- NT-proBNP, MPO, NLR, echocardiography and their combination for predicting malignant arrhythmia
- Outcome
- Prediction of malignant arrhythmias (MA) (ROC AUC)
- Follow-up
- 1 year
Methodological details1-year follow-up
- 1-year follow-up
Performance
As reported in the abstract
Prediction of MA
| Test or model | AUC | Sensitivity | Specificity | 95% CI |
|---|---|---|---|---|
| NT-proBNP | 0.782 | 61.50% | 94.60% | 0.630-0.934 |
| MPO | 0.759 | 69.20% | 81.10% | 0.579-0.938 |
| NLR | 0.736 | 76.90% | 64.90% | 0.562-0.910 |
| Echocardiography | 0.782 | 76.90% | 75.70% | 0.646-0.918 |
| Combined | 0.913 | 76.90% | 94.60% | 0.820-1.000 |
AUC
NT-proBNP0.782
MPO0.759
NLR0.736
Echocardiography0.782
Combined0.913
Sensitivity
NT-proBNP61.50%
MPO69.20%
NLR76.90%
Echocardiography76.90%
Combined76.90%
Specificity
NT-proBNP94.60%
MPO81.10%
NLR64.90%
Echocardiography75.70%
Combined94.60%
95% CI
NT-proBNP0.630-0.934
MPO0.579-0.938
NLR0.562-0.910
Echocardiography0.646-0.918
Combined0.820-1.000
- Combined vs each parameter alone: P < 0.05 — combined AUC higher
Further findings
Biomarker levels
- MPO, NT-proBNP and NLR higher in VHD group and with severe cardiac dysfunction
- MPO, NT-proBNP, NLR and LVESV higher in malignant arrhythmias (MA) group
Independent factors for MA
- NT-proBNP an independent factor influencing occurrence of MA
Original publication
Clinical value of NT-proBNP, MPO, and NLR combined with echocardiography in prediction of malignant arrhythmia in elderly patients with valvular heart disease. Perioper Med (Lond). Published 22 April 2025. doi:10.
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