Abstract |
We investigated whether N-terminal pro- brain natriuretic peptide (NT-pro-BNP) that was measured on admission in patients with acute myocardial infarction (AMI) predicts the efficacy of reperfusion or whether NT-pro-BNP provides prognostic information independent of infarct size as estimated by single-photon emission computed tomographic scintigraphy. The study included 174 patients with ST-segment elevation AMI who were admitted within 24 hours of pain onset. NT-pro-BNP level was measured on admission. Paired scintigraphic studies (before and 7 to 14 days after reperfusion) were performed to assess infarct size and define myocardial salvage. One-year clinical follow-up was assessed. Patients were categorized into the high NT-pro-BNP group (57 patients in the upper tertile of NT-pro-BNP) and low NT-pro-BNP group (117 patients in the middle and lower tertiles of NT-pro-BNP). Initial median perfusion defect was 35.0% (interquartile rage 20.0 to 53.0%) of the left ventricle in the high NT-pro-BNP group versus 19.0% (interquartile range 10.0 to 32.2) of the left ventricle in the low NT-pro-BNP group (p <0.001). Median salvage index was 0.36 (interquartile range 0.16 to 0.86) in the high NT-pro-BNP group versus 0.53 (interquartile range 0.31 to 0.75) in the low NT-pro-BNP group (p = 0.22). After adjustment in Cox's proportional hazards model, NT-pro-BNP remained an independent correlate of 1-year mortality (adjusted hazard ratio 2.31, 95% confidence interval 1.09 to 4.89, p = 0.03, high vs low NT-pro-BNP group). In conclusion, NT-pro-BNP measured on admission in patients with AMI correlates with scintigraphic area at risk and predicts prognosis but does not predict the efficacy of mechanical reperfusion by stenting or angioplasty.
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Authors | Gjin Ndrepepa, Siegmund Braun, Julinda Mehilli, Nicolas von Beckerath, Stephan Nekolla, Wolfgang Vogt, Markus Schwaiger, Albert Schömig, Adnan Kastrati |
Journal | The American journal of cardiology
(Am J Cardiol)
Vol. 97
Issue 8
Pg. 1151-6
(Apr 15 2006)
ISSN: 0002-9149 [Print] United States |
PMID | 16616017
(Publication Type: Journal Article)
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Chemical References |
- Peptide Fragments
- Radiopharmaceuticals
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
- Technetium Tc 99m Sestamibi
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Topics |
- Aged
- Coronary Circulation
- Female
- Follow-Up Studies
- Heart
(diagnostic imaging)
- Heart Ventricles
(diagnostic imaging)
- Humans
- Male
- Middle Aged
- Myocardial Infarction
(blood, diagnostic imaging, mortality, therapy)
- Myocardial Reperfusion
- Natriuretic Peptide, Brain
(blood)
- Patient Admission
- Peptide Fragments
(blood)
- Prognosis
- Proportional Hazards Models
- Prospective Studies
- Radiopharmaceuticals
- Technetium Tc 99m Sestamibi
- Tomography, Emission-Computed, Single-Photon
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