title: Plasma B-type natriuretic peptide level can predict myocardial tissue perfusion in patients undergoing primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Inadequate myocardial tissue perfusion after successful revascularization in ST-segment elevation myocardial infarction (STEMI) is associated with worse clinical outcomes. We investigated whether the plasma B-type natriuretic peptide (BNP) level on admission could predict the status of myocardial tissue perfusion in patients who underwent primary percutaneous coronary intervention (PCI).
  
  
  METHODS
  The study prospectively enrolled 102 patients with STEMI who underwent primary PCI within 12 h of symptom onset. The grade of myocardial tissue perfusion was measured by ST-segment resolution, corrected thrombolysis in myocardial infarction frame count, and myocardial blush grade after primary PCI. All-cause mortality at 1 month after PCI was assessed.
  
  
  RESULTS
  All patients were divided into two groups according to the BNP level; high-BNP group (≥80 pg/ml, n=43) and low-BNP group (<80 pg/ml, n=59). High-BNP group had significantly lower ST-segment resolution (42.69 ± 24.85 vs. 71.15 ± 19.37%, P<0.001), higher corrected thrombolysis in myocardial infarction frame count (53.7 ± 19.7 vs. 44.5 ± 15.5, P=0.04), lower myocardial blush grade (2.4 ± 0.9 vs. 2.9 ± 0.3, P=0.001), and higher short-term mortality (16.2 vs. 3.3%, P=0.023). In multivariate logistic regression analysis for prediction of good myocardial tissue perfusion after PCI, the odds ratio of low-BNP group was 4.12 (95% confidence interval 1.49-13.08, P<0.01).
  
  
  CONCLUSIONS
  The patients with STEMI who had higher BNP level on admission showed inadequate myocardial tissue perfusion status after primary PCI. The plasma BNP level on admission may serve as a predictor of tissue perfusion after primary PCI in patients with STEMI.
authors.affiliation: Division of Cardiovascular Center and Cardiology, Incheon St. Mary's Hospital, Korea.
authors.forename: Suk Min
authors.initials: SM
authors.lastname: Seo
authors.forename: Seonghun
authors.initials: S
authors.lastname: Kim
authors.forename: Kiyuk
authors.initials: K
authors.lastname: Chang
authors.forename: Jinsoo
authors.initials: J
authors.lastname: Min
authors.forename: Tae Hoon
authors.initials: TH
authors.lastname: Kim
authors.forename: Yoon Seok
authors.initials: YS
authors.lastname: Koh
authors.forename: Hun Jun
authors.initials: HJ
authors.lastname: Park
authors.forename: Woo Seung
authors.initials: WS
authors.lastname: Shin
authors.forename: Jong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Pum-Joon
authors.initials: PJ
authors.lastname: Kim
authors.forename: Wook-Sung
authors.initials: WS
authors.lastname: Chung
authors.forename: Ki-Bae
authors.initials: KB
authors.lastname: Seung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D003326:Coronary Circulation; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; 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; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain