title: Usefulness of NT-proBNP in the Follow-Up of Patients after Myocardial Infarction.
abstract: BACKGROUND
  Since serial analyses of NT-proBNP in patients with acute coronary syndromes have shown that levels measured during a chronic, later phase are a better predictor of prognosis and indicator of left ventricular function than the levels measured during an acute phase, we sought to assess the association of NT-proBNP, measured 6 months after acute myocardial infarction (AMI), with traditional risk factors, characteristics of in-hospital and early postinfarction course, as well as its prognostic value and optimal cut-points in the ensuing 1-year follow-up.
  
  
  METHODS
  Fasting venous blood samples were drawn from 100 ambulatory patients and NT-proBNP concentrations in lithium-heparin plasma were determined using a one-step enzyme immunoassay based on the »sandwich« principle on a Dimension RxL clinical chemistry system (DADE Behring-Siemens). Patients were followed-up for the next 1 year, for the occurrence of new cardiac events.
  
  
  RESULTS
  Median (IQR) level of NT-proBNP was 521 (335-1095) pg/mL. Highest values were mostly associated with cardiac events during the first 6 months after AMI. Negative association with reperfusion therapy for index infarction confirmed its long-term beneficial effect. In the next one-year follow-up of stable patients, multivariate Cox regression analysis revealed the independent prognostic value of NT-proBNP for new-onset heart failure prediction (p=0.014), as well as for new coronary events prediction (p=0.035). Calculation of the AUCs revealed the optimal NT-proBNP cut-points of 800 pg/mL and 516 pg/mL, respectively.
  
  
  CONCLUSIONS
  NT-proBNP values 6 months after AMI are mainly associated with the characteristics of early infarction and postinfarction course and can predict new cardiac events in the next one-year follow-up.
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia and Medical School, University of Belgrade.
authors.forename: Mina
authors.initials: M
authors.lastname: Radosavljevic-Radovanovic
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia and Medical School, University of Belgrade.
authors.forename: Nebojsa
authors.initials: N
authors.lastname: Radovanovic
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia and Medical School, University of Belgrade.
authors.forename: Zorana
authors.initials: Z
authors.lastname: Vasiljevic
authors.affiliation: Institute of Statistics, Medical School, University of Belgrade, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Marinkovic
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia and Medical School, University of Belgrade.
authors.forename: Predrag
authors.initials: P
authors.lastname: Mitrovic
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia and Medical School, University of Belgrade.
authors.forename: Igor
authors.initials: I
authors.lastname: Mrdovic
authors.affiliation: Centre of Medical Biochemistry, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Sanja
authors.initials: S
authors.lastname: Stankovic
authors.affiliation: International Clinical Research Center, St Anne's University Hospital, Brno, Czech Republic.
authors.forename: Peter
authors.initials: P
authors.lastname: Kružliak
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia and Medical School, University of Belgrade.
authors.forename: Branko
authors.initials: B
authors.lastname: Beleslin
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Ana
authors.initials: A
authors.lastname: Uscumlic
authors.affiliation: Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Kostic
keywords: N-terminal pro-brain natriuretic peptide; myocardial infarction; postinfarction period; prognostic neurohumoral testing