The optimal time of B-type natriuretic peptide sampling associated with post-myocardial infarction remodelling after primary percutaneous coronary intervention.
OBJECTIVE
To find the optimal time to evaluate plasma B-type natriuretic peptide (BNP), which is related to post-myocardial infarction remodelling (PMIR), we measured serial plasma BNP levels according to time protocols after primary percutaneous coronary intervention (PCI).


BACKGROUND
It has been established that plasma BNP levels can predict the development of PMIR in patients with ST-elevation myocardial infarction (STEMI). However, the time of plasma BNP sampling associated with PMIR is still controversial.


METHODS
We analysed 42 patients who were diagnosed as PMIR on six-month follow-up echocardiography among 131 patients with STEMI. We then compared clinical variables including plasma BNP between the remodelling group and the non-remodelling group. The plasma BNP level was obtained on hospital admission (acute phase), at two to five days (early phase), three to four weeks (late phase) and at the six-month follow up (long term).


RESULTS
Early-phase and long-term BNP levels were higher in the remodelling group. The serial plasma BNP levels, according to study protocols, showed a biphasic pattern of elevation. In multiple logistic regression analyses, early-phase BNP [odds ratio (OR): 1.013, p < 0.01] and acute-phase BNP levels (OR: 1.007, p = 0.02) were independent predictors of PMIR. However, early-phase BNP level was statistically a more powerful predictor of PMIR during follow up.


CONCLUSIONS
Consecutive BNP levels after primary PCI showed a biphasic peak elevation during follow up. Early-phase plasma BNP level was an independent predictor of PMIR in patients with STEMI.
Top Care Cardiovascular Centre, Gumdan Top Hospital, Dangha-dong, Seo-gu, Incheon, South Korea.
Hyunmin
H
Choi
Byung-Su
BS
Yoo
Joon-Hyung
JH
Doh
Hee-Jeong
HJ
Yooh
Min-Soo
MS
Ahn
Jang-Young
JY
Kim
Seung-Hwan
SH
Lee
Junghan
J
Yoon
D000368:Aged; D002985:Clinical Protocols; D015150:Echocardiography, Doppler; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000601:surgery; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D062645:Percutaneous Coronary Intervention; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011379:Prognosis; D013318:Stroke Volume; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis* / Q000209:etiology; D020257:Ventricular Remodeling
D020097:Natriuretic Peptide, Brain