title: Role of N-terminal pro-brain natriuretic peptide in ST-segment elevation myocardial infarction: experience from a tertiary centre in India.
abstract: BACKGROUND
  Role of biomarkers in ST-segment elevation myocardial infarction (STEMI) is paramount, as they aid in diagnosis and gauge prognosis of the disease. In this project, we sought to study the short-term outcome and clinical associates of N-terminal pro-brain natriuretic peptide (NT-proBNP) in the setting of STEMI at a tertiary center in India.
  
  
  METHODS
  In all, 173 STEMI patients (mean age: 57 ± 12 years, 38 women) had their NT-proBNP assayed in addition to troponins and high-sensitive C-reactive protein. Subjects were divided according to NT-proBNP levels into 2 groups: group 1 (NT-proBNP ≤100 pg/mL) and group 2 (NT-proBNP >100 pg/mL).
  
  
  RESULTS
  NT-proBNP values (pg/mL) were elevated in group 2 (group 1: 61.7 ± 6.2; group 2: 1006.5 ± 990.6, P < 0.0001). Significantly greater number of females had elevated NT-proBNP (P < 0.05) that could be predicted by the duration of chest pain related to STEMI (area under the curve: 0.72), and age at presentation (area under the curve: 0.66). Multiple regression analysis showed a strong inverse association between NT-proBNP and left ventricular ejection fraction and a strong positive association between the peptide and high-sensitive C-reactive protein. A significant positive association was also noted between NT-proBNP and troponin I (all P < 0.05, Global R = 0.47). Diabetes mellitus and/or hypertension, and infarction localization showed no effect on NT-proBNP levels along with death, primary coronary intervention-related bleeding, and arrhythmias, (χ, P = ns).
  
  
  CONCLUSIONS
  The data suggest that women are more likely to have increased NT-proBNP while presenting with STEMI. Duration of chest pain and age at presentation are the best predictors of elevated NT-proBNP, though without much bearing on short-term morbidity and mortality.
authors.affiliation: Division of Cardiology, VIVUS-BMJ Heart Centre, Bangalore, India.
authors.forename: Satish C
authors.initials: SC
authors.lastname: Govind
authors.forename: Anatoli
authors.initials: A
authors.lastname: Kiotsekoglou
authors.forename: Varuna K
authors.initials: VK
authors.lastname: Gadiyaram
authors.forename: Aasha S
authors.initials: AS
authors.lastname: Gopal
authors.forename: Lars-Åke
authors.initials: LÅ
authors.lastname: Brodin
authors.forename: Saligrama S
authors.initials: SS
authors.lastname: Ramesh
authors.forename: Samir K
authors.initials: SK
authors.lastname: Saha
mesh_terms: D000367:Age Factors; D000368:Aged; D015415:Biomarkers; D002097:C-Reactive Protein / Q000378:metabolism; D015897:Comorbidity; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011237:Predictive Value of Tests; D011379:Prognosis; D012737:Sex Factors; D014336:Troponin / Q000378:metabolism
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D014336:Troponin; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein