Prognostic significance of the admission plasma B-type natriuretic peptide measurement in patients with first ST-elevation myocardial infarction in comparison with C-reactive protein and TIMI risk score.

Abstract

BACKGROUND:

In ST-elevation myocardial infarction (STEMI) B-type natriuretic peptide (BNP) holds promise for risk stratification. Aim of this study was to assess prognostic value of plasma BNP measurement and to compare with other powerful prognostic markers -- TIMI Risk Score (TRS) and C-reactive protein (CRP) in patients with first STEMI treated with primary PCI (pPCI).

METHODS:

86 patients, admitted within initial 12 h of the first STEMI. Admission plasma levels of BNP were measured by MEIA method. Serum levels of CRP were measured using immunoturbidimetric assays. Composite end point (CEP) was assessed after 7 months.

RESULTS:

Median plasma BNP value was higher in patients with CEP, compared with those without CEP (p<0.001). Patients with plasma BNP >99.2 pg/mL were at significantly higher risk for CEP (the highest sensitivity and specificity). CRP level >10.6 mg/dL was also associated with poor outcome. TRS has not influenced the occurrence of CEP. In the analysis of logistic regression the BNP value >99.2 pg/mL was the strongest predictor of CEP. ROC analysis identified BNP measurement as significant to estimate adverse outcome 0.950 in the prediction of CEP (95% Confidence interval=0.878-0.985).

CONCLUSION:

Admission plasma BNP concentrations provide incremental prognostic information in patients with first STEMI treated with pPCI.

• Authors: Agnieszka M Kuklinska, Bozena Sobkowicz, Barbara Mroczko, Robert Sawicki, Wlodzimierz J Musial, Malgorzata Knapp, Slawomir Dobrzycki, Maciej Szmitkowski
• Journal: Clinica chimica acta; international journal of clinical chemistry (Clin Chim Acta) Vol. 382 Issue 1-2 Pg. 106-11 (Jul 2007) ISSN: 0009-8981 [Print] Netherlands
• PMID: 17482153 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Natriuretic Peptide, Brain
• C-Reactive Protein

Topics

• Aged
• Angioplasty, Balloon, Coronary
• Arrhythmias, Cardiac
• C-Reactive Protein (analysis, metabolism)
• Female
• Humans
• Male
• Middle Aged
• Myocardial Infarction (blood, physiopathology, therapy)
• Natriuretic Peptide, Brain (blood)
• Predictive Value of Tests
• Prognosis
• Prospective Studies
• ROC Curve
• Risk Assessment
• Severity of Illness Index