N-terminal pro-B-type natriuretic peptide is associated with adverse short-term clinical outcomes in patients with acute ST-elevation myocardial infarction underwent primary percutaneous coronary intervention.
BACKGROUND
Increased level of N-terminal pro-B type natriuretic peptide (NT-proBNP) is known to be associated with adverse outcome in patients with acute coronary syndrome. We evaluated early outcomes of patients with acute ST-elevated myocardial infarction (STEMI) according to the level of NT-proBNP as a substudy of Korean Acute Myocardial Infarction Registry (KAMIR).


METHODS
Study population consisted of 1052 consecutive patients (mean 61.3+/-12.8 years old, male 73.2%) with STEMI of onset <12 h who underwent primary percutaneous coronary intervention (PCI) and who had baseline NT-proBNP level by electrochemiluminescence immnunoassay (ECLIA, NT-proBNP kit, Roche Diagnostics, Mannheim, Germany). The study subjects were divided into two groups according to the level of serum NT-proBNP.


RESULTS
Patients with NT-proBNP level >991 pg/mL (n=329, 57.1% male) had lower left ventricle ejection fraction (LVEF) (47.8+/-11.8% vs. 53.0+/-10.8%, p<0.001), needed longer intensive care (3.7+/-3.6 days vs. 2.8+/-2.4 days, p<0.001) and had higher in-hospital mortality (1.3% vs. 7.4%, p<0.001) than those with NT-proBNP level<or=991 pg/mL (n=723, 80.5% male). Multiple logistic regression analysis revealed that the independent predictors of in-hospital mortality were LVEF<45% (OR 5.43, 95% CI 1.71 to 17.29, p=0.004), elevated NT-proBNP (>991 pg/mL) (OR 3.70, 95% CI 1.14 to 12.03, p=0.030), old age (>or=70 years) (OR 4.71, 95% CI 1.43 to 15.52, p=0.011), advanced Killip class (>1) (OR 4.96, 95% CI 1.58 to 15.53, p=0.006), male gender (OR 5.67, 95% CI 1.45 to 22.21, p=0.013) and TIMI flow 0 before PCI (OR 5.04, 95% CI 1.08 to 23.41, p=0.039).


CONCLUSIONS
This study suggests that baseline NT-proBNP level is associated with short term mortality in patients with STEMI underwent primary PCI.
Kwon
Taek Geun
TG
Cardiology, Heart Center, Konyang University Hospital, Deajeon, South Korea.
Bae
Jang Ho
JH
Jeong
Myung Ho
MH
Kim
Young Jo
YJ
Hur
Seung Ho
SH
Seong
In Whan
IW
Cho
Myeong Chan
MC
Seung
Ki Bae
KB
Jang
Yang Soo
YS
Park
Seung Jung
SJ
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality*; D015415:Biomarkers / Q000097:blood; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000401:mortality / Q000628:therapy; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D016896:Treatment Outcome
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain