title: Admission B-type natriuretic peptide level predicts long-term survival in low risk ST-elevation myocardial infarction patients.
abstract: BACKGROUND
  In patients with acute myocardial infarction (AMI), B-type natriuretic peptide (BNP) is a predictor of short- and medium-term mortality.
  
  
  OBJECTIVE
  To evaluate the long-term prognostic value of a single measurement of plasma BNP in low risk patients with first ST-elevation myocardial infarction (STEMI).
  
  
  METHODS
  Plasma BNP concentrations were analysed on admission in 211 patients, median age 68 (56.0-75.0) years, admitted with first STEMI and treated with primary percutaneous coronary intervention (PPCI). Left ventricular ejection fraction (LVEF) was assessed by echocardiography during the first 24 h. Patients were followed for a median 48.2 (42.3-72.6) months.
  
  
  RESULTS
  The median BNP level was 92.5 (36.3-199.2) pg/mL. During the follow-up period, 79.6% of patients survived. Logistic regression analysis indicated that among the assessed clinical, biochemical, angiographic and echocardiographic parameters, the best predictors of mortality were age, LVEF, maximal creatinine concentration and BNP measurements, (p < 0.05). In multivariate Cox regression analysis for the prediction of death, only age remained significant (p = 0.00007). Admission BNP level > 400 pg/mL indicated patients with the highest risk of death (47.1% vs 22% and 18.4% in patients with BNP level < 100 pg/mL and 100-400 pg/mL, respectively; p < 0.05).
  
  
  CONCLUSIONS
  A single measurement of BNP on admission can improve long-term risk stratification in low risk first STEMI patients treated with PPCI.
authors: Department of Cardiology, Medical University of Bialystok, Bialystok, Poland.
authors: Agnieszka M
authors: AM
authors: Tycińska
authors: Robert
authors: R
authors: Sawicki
authors: Barbara
authors: B
authors: Mroczko
authors: Bożena
authors: B
authors: Sobkowicz
authors: Włodzimierz J
authors: WJ
authors: Musiał
authors: Sławomir
authors: S
authors: Dobrzycki
authors: Ewa
authors: E
authors: Waszkiewicz
authors: Anna
authors: A
authors: Kozieradzka
authors: Maciej
authors: M
authors: Szmitkowski
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood*; D003955:Diagnostic Tests, Routine / Q000401:mortality*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011237:Predictive Value of Tests; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D015415:Biomarkers; D020097:Natriuretic Peptide, Brain