Original scientific paper
B-type Natriuretic Peptide as Predictor of Heart Failure in Patients with Acute ST Elevation Myocardial Infarction, Singlevessel Disease, and Complete Revascularization: Follow-up Study
Šime Manola
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Nikola Pavlović
orcid.org/0000-0001-9187-7681
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Vjekoslav Radeljić
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Diana Delić Brkljačić
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Hrvoje Pintarić
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Krešimir Štambuk
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Nikola Bulj
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Matias Trbušić
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Tomislav Krčmar
; Department of Cardiology, Sisters of Mercy University Hospital, Zagreb, Croatia
Ljerka Lukinac
; Department of Oncology and Nuclear Medicine, Sisters of Mercy University Hospital Zagreb, Croatia
Abstract
Aim To assess the concentration of B-type natriuretic peptide
(BNP) as a predictor of heart failure in patients with
acute ST elevation myocardial infarction (STEMI) who underwent
primary percutaneous coronary intervention (PCI)
with successful and complete revascularization.
Methods Out of a total of 220 patients with acute STEMI
admitted to the Sisters of Mercy University Hospital in
the period January 1 to December 31, 2007, only patients
with acute STEMI undergoing primary PCI who had single
vessel disease and were successfully revascularized were
included in the study. Selected patients had no history of
myocardial infarction or heart failure and a normal or nearnormal
left ventricular ejection fraction (≥50%) assessed by
left ventriculography at admission. Only 58 patients met
the inclusion criteria for the study. Out of those, 6 patients
refused to participate in the study, and another 5 could not
be followed up, so a total of 47 patients were evaluated.
Blood samples were taken for measurement of BNP levels
at admission, 24 hours later, and 7 days later. Patients were
followed up for 1 year. The primary outcome was reduction
in left ventricular ejection fraction (LVEF) to <50% after
1 year.
Results Patients who developed echocardiographic signs
of reduced systolic function defined as LVEF<50% had significantly
higher values of BNP (≥80 pg/mL) at 24 hours
(P = 0.001) and 7 days (P = 0.020) after STEMI and successful
reperfusion. Patients who had BNP levels ≥80 pg/mL after
7 days were 21 times more likely to develop LVEF<50 (odds
ratio, 20.8; 95% confidence interval, 2.2-195.2; P = 0.008).
Conclusion BNP can be used as a predictor of reduced
systolic function in patients with STEMI who underwent
successful reperfusion and had normal ejection fraction at
admission.
Keywords
brain natriuretic peptide; natriuretic peptides; acute myocardial infarction; primary coronary angioplasty
Hrčak ID:
47865
URI
Publication date:
15.10.2009.
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