Abstract | BACKGROUND: METHODS: RESULTS: According to classification tree analysis, patients with Nt-proBNP levels >694 pg/mL had the highest primary end point rates (33.8% vs 11%, P < .001). In Cox regression analysis, Nt-proBNP >694 pg/mL strongly predicted 90-day survival even among patients with short treatment delay (f-PCI < or =3 hours: hazard ratio [HR] 2.63, P = .002 and p-PCI < or =3 hours: HR 4.87, P < .001, respectively). Patients with TIMI 3 flow after coronary intervention were at significantly higher risk of the primary end point if admission Nt-proBNP exceeded 694 pg/mL (f-PCI: HR 2.88, P < .001 and p-PCI: HR 3.84, P < .001, respectively). In multivariable analysis, Nt-proBNP >694 pg/mL significantly (P = .001) predicted 90-day survival in addition to age (P < .001), TIMI flow after PCI (P < .001), body mass index (P = .026), anterior wall infarction (P = .035), and systolic blood pressure at randomization (P = .036), respectively. CONCLUSION: Elevated plasma concentrations of Nt-proBNP in the early phase of STEMI determine in-hospital and 90-day outcome after infarction irrespective of time to treatment and pre- or postinterventional TIMI flow.
|
Authors | Rudolf Jarai, Kurt Huber, Kris Bogaerts, Walter Droogne, Justin Ezekowitz, Christopher B Granger, Peter R Sinnaeve, Allan M Ross, Uwe Zeymer, Paul W Armstrong, Frans J Van de Werf, ASSENT IV-PCI investigators |
Journal | American heart journal
(Am Heart J)
Vol. 159
Issue 1
Pg. 131-40
(Jan 2010)
ISSN: 1097-6744 [Electronic] United States |
PMID | 20102879
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial)
|
Copyright | Copyright 2010 Mosby, Inc. All rights reserved. |
Chemical References |
- Biomarkers
- Peptide Fragments
- pro-brain natriuretic peptide (1-76)
- Natriuretic Peptide, Brain
- Tissue Plasminogen Activator
- Tenecteplase
|
Topics |
- Aged
- Analysis of Variance
- Angioplasty, Balloon, Coronary
(methods, mortality)
- Biomarkers
(blood)
- Combined Modality Therapy
- Confidence Intervals
- Coronary Angiography
(methods)
- Coronary Circulation
(drug effects, physiology)
- Early Diagnosis
- Female
- Follow-Up Studies
- Humans
- Male
- Middle Aged
- Multivariate Analysis
- Myocardial Infarction
(blood, diagnostic imaging, mortality, therapy)
- Natriuretic Peptide, Brain
(blood)
- Peptide Fragments
(blood)
- Predictive Value of Tests
- Probability
- Prospective Studies
- Risk Assessment
- Survival Analysis
- Tenecteplase
- Thrombolytic Therapy
(methods)
- Time Factors
- Tissue Plasminogen Activator
(therapeutic use)
- Treatment Outcome
- Vascular Patency
(drug effects, physiology)
|