title: Plasma level of B-type natriuretic peptide as a prognostic marker after acute myocardial infarction: a long-term follow-up analysis.
abstract: 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.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Suzuki
authors.forename: Michihiro
authors.initials: M
authors.lastname: Yoshimura
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nakayama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizuno
authors.forename: Eisaku
authors.initials: E
authors.lastname: Harada
authors.forename: Teruhiko
authors.initials: T
authors.lastname: Ito
authors.forename: Shota
authors.initials: S
authors.lastname: Nakamura
authors.forename: Koji
authors.initials: K
authors.lastname: Abe
authors.forename: Megumi
authors.initials: M
authors.lastname: Yamamuro
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
authors.forename: Kazuwa
authors.initials: K
authors.lastname: Nakao
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasue
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: 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
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain