Prognostic value of B-type natriuretic peptide levels on admission in patients with acute ST elevation myocardial infarction.
OBJECTIVE
To assess the relation between B-type natriuretic peptide (BNP) levels on admission in ST elevation myocardial infarction (STEMI) and short-term, all-cause mortality.


RESULTS
Blood samples for BNP determination were obtained on admission in 88 patients (mean age 60.6 +/- 10.7 years old) with STEMI. In a 15-minute period, BNP was measured by using simple bedside test for rapid quantification of BNP. Thirty days follow-up was performed. During the period of follow-up 12 (13.6%) patients died. Mean BNP was 228.74 +/- 269.98 pg/ml. The lowest value was 5 pg/ml, the highest value 1300 pg/ml due to limitations of the method. The baseline level of BNP was higher among patients who died than among those who were alive at 30 days (mean, 545.6 vs. 178.7 pg/ml; P = 0.001). Mortality increased among patients in increasing quartiles (p = 0.009). The unadjusted odds ratio for 30-day risk of death in the fourth quartile was 5.6 (95 percent confidence interval, 1.6 to 20.5; P < 0.001). When BNP was added to a multivariate Cox regression model including clinical and electrocardiographic variables, BNP levels were independently associated with the prognosis.


CONCLUSIONS
BNP levels obtained on admission are a powerful, independent indicator of short-term mortality in patients with STEMI. Rapid tests for BNP assay seem to be a new tool in risk stratification of patients with STEMI.
Grabowski
Marcin
M
1st Department of Cardiology, Medical University of Warsaw, Central University Hospital, Warsaw, Poland. marcin.grabowski@amwaw.edu.pl
Filipiak
Krzysztof J
KJ
Karpinski
Grzegorz
G
Wretowski
Dominik
D
Rdzanek
Adam
A
Rudzki
Dariusz
D
Główczyńska
Renata
R
Rudowski
Robert
R
Opolski
Grzegorz
G
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016017:Odds Ratio; D010343:Patient Admission; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D016896:Treatment Outcome
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain