Plasma level of B-type natriuretic peptide as a prognostic marker after acute myocardial infarction: a long-term follow-up analysis.
BACKGROUND
Circulating levels of B-type natriuretic peptide (BNP), a cardiac hormone, reflect the severity of cardiac dysfunction. Because the plasma BNP level changes dramatically during the period after the onset of acute myocardial infarction (AMI), identification of a suitable sampling time is problematic. There have been several reports indicating that the plasma BNP level obtained in the acute phase of AMI can be used as a prognostic marker. We examined whether the plasma BNP level measured 3 to 4 weeks after the onset of AMI represents a reliable prognostic marker for patients with AMI.


RESULTS
We analyzed 145 consecutive patients with AMI. Plasma BNP levels were measured during the 3 to 4 weeks after onset of AMI. Of those patients, 23 experienced fatal cardiac events during this study. The mean follow-up period was 58.6 months. Log BNP, left ventricular end-diastolic pressure, and pulmonary vascular resistance were all significantly higher in the cardiac death group, and there were more men and more patients with a history of heart failure in the cardiac death group. A Cox proportional hazards model analysis showed that log BNP was an independent predictor of cardiac death. The survival rate was significantly higher in patients with log BNP <2.26 (180 pg/mL) than in those with log BNP > or =2.26.


CONCLUSIONS
The plasma BNP level obtained 3 to 4 weeks after the onset of AMI can be used as an independent predictor of cardiac death in patients with AMI.
Suzuki
Satoru
S
Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Yoshimura
Michihiro
M
Nakayama
Masafumi
M
Mizuno
Yuji
Y
Harada
Eisaku
E
Ito
Teruhiko
T
Nakamura
Shota
S
Abe
Koji
K
Yamamuro
Megumi
M
Sakamoto
Tomohiro
T
Saito
Yoshihiko
Y
Nakao
Kazuwa
K
Yasue
Hirofumi
H
Ogawa
Hisao
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers; D006328:Cardiac Catheterization; D002423:Cause of Death; D003289:Convalescence; D003645:Death, Sudden / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology; D006439:Hemodynamics; D006801:Humans; D015993:Life Tables; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009369:Neoplasms / Q000401:mortality; D011014:Pneumonia / Q000401:mortality; D016016:Proportional Hazards Models; D016019:Survival Analysis; D015996:Survival Rate
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain