N-terminal pro-brain natriuretic peptide level in relation to epicardial and myocardial reperfusion in ST-segment elevation myocardial infarction treated with facilitated angioplasty.
The aims of this study were firstly to evaluate the relations between N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration after ST-segment elevation myocardial infarction (STEMI) and reperfusion injury, and secondly to assess the prognostic value of NT-proBNP.


RESULTS
We evaluated 202 consecutive patients with STEMI treated with facilitated angioplasty (PCI). TIMI flow, TIMI myocardial perfusion grade (TMPG) and ST-segment elevation resolution (iST) were assessed before O and 30 minutes (O30) after PCI. Enzymatic injury was expressed as an area under the curve of CK-MB release (AUC, [Uxh]). 48 hours after PCI, the concentration of NT-proBNP ([pg/ml]) and echocardiography-determined left ventricle ejection fraction (LVEF, [%]) were assessed. Death and heart failure (HF) requiring hospitalisation were recorded during a 1-year follow-up and defined as a composite endpoint. NT-proBNP concentration 48 hours after PCI was correlated with iST-O (p<0,001; r=0,48), iST-O30 (p<0,001; r=0,57), AUC (p<0,001; r=0,54) and LVEF (p<0,001; r=-0,5). Increasing quartiles of NT-proBNP were related to mortality (p=0,0012) as well as to composite endpoint (p=0,0012) at 1 year. 4th-quartile of NT-proBNP was independently associated with a composite endpoint at a 1-year follow-up.


CONCLUSIONS
NT-proBNP level after STEMI was moderately correlated with the degree of microvascular reperfusion and myocardial injury and function. NT-proBNP was independently associated with the frequency of death and HF requiring hospitalisation.
Zmudka
Krzysztof
K
Department of Haemodynamics and Angiocardiography, Institute of Cardiology, Jagiellonian University, Krakow, Poland.
Zalewski
Jaroslaw
J
El-Massri
Nader
N
Stepien
Ewa
E
Zajdel
Wojciech
W
Durak
Monika
M
Dudek
Dariusz
D
Przewlocki
Tadeusz
T