title: In-hospital prognostic value of admission plasma B-type natriuretic peptide levels in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction.
abstract: OBJECTIVE
  We assessed in-hospital prognostic value of admission plasma B-type natriuretic peptide (BNP) levels in patients undergoing primary percutaneous coronary intervention (p-PCI) for acute ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  In a retrospective design, we evaluated 992 patients (801 males, 191 females; mean age 56 ± 12 years) treated with p-PCI for STEMI. The patients were divided into two groups according to the admission BNP levels, taking the cut-off value of BNP as 100 pg/ml; i.e, ≥ 100 pg/ml (n=334, 33.7%) and <100 pg/ml (n=658, 66.3%). Postprocedural angiographic and clinical in-hospital results were recorded.
  
  
  RESULTS
  No-reflow (24% vs. 9%), heart failure (32.3% vs. 5.5%) and death (15.6% vs. 1.7%) were significantly more common in patients with BNP ≥ 100 pg/ml (p<0.001). In multivariate analysis, elevated baseline BNP level was identified as an independent predictor of no-reflow (OR=1.83; 95% CI 1.22-2.74, p=0.003), acute heart failure (OR=2.67; 95% CI 1.55-4.58, p<0.001), and in-hospital mortality (OR=3.28; 95% CI 1.51-7.14, p=0.003). In receiver operating characteristic curve analysis, the area under the curve and sensitivity/specificity of the cut-off value of BNP (100 pg/ml) for prediction of clinical endpoints were 0.741 and 58.6%/70.3% for no-reflow, 0.822 and 75%/73.3% for heart failure, and 0.833 and 82.5%/69.4% for death, respectively (p<0.001 for all).
  
  
  CONCLUSIONS
  Elevated admission BNP level is an independent predictor of angiographic no-reflow, acute heart failure, and mortality in STEMI patients during in-hospital period, suggesting that it might be incorporated into traditional risk scoring systems to improve early risk stratification.
authors: Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, İstanbul, Turkey. voduncu@yahoo.com
authors: Vecih
authors: V
authors: Oduncu
authors: Ayhan
authors: A
authors: Erkol
authors: Ali Cevat
authors: AC
authors: Tanalp
authors: Cihan
authors: C
authors: Dündar
authors: Ibrahim Halil
authors: IH
authors: Tanboğa
authors: Dicle
authors: D
authors: Sırma
authors: Ali
authors: A
authors: Karagöz
authors: Can Yücel
authors: CY
authors: Karabay
authors: Akın
authors: A
authors: Izgi
authors: Selçuk
authors: S
authors: Pala
authors: Kürşat
authors: K
authors: Tigen
authors: Cevat
authors: C
authors: Kırma
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D056988:Anterior Wall Myocardial Infarction / Q000097:blood* / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D020097:Natriuretic Peptide, Brain