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.
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).


CONCLUSIONS
Admission plasma BNP concentrations provide incremental prognostic information in patients with first STEMI treated with pPCI.
Kuklinska
Agnieszka M
AM
Department of Cardiology, Medical University, Bialystok, Poland ul Sklodowskiej-Curie 24a, Bialystok, Poland. kuklinska@poczta.onet.pl
Sobkowicz
Bozena
B
Mroczko
Barbara
B
Sawicki
Robert
R
Musial
Wlodzimierz J
WJ
Knapp
Malgorzata
M
Dobrzycki
Slawomir
S
Szmitkowski
Maciej
M
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001145:Arrhythmias, Cardiac; D002097:C-Reactive Protein / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012720:Severity of Illness Index
D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein