BACKGROUND: B-type natriuretic peptide (BNP) levels are predictive of short-term death in patients with acute coronary syndromes. Few data are available for BNP levels obtained on admission in patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: Blood samples for BNP estimation, obtained on admission in 126 consecutive patients (mean age, 58.8 +/- 10.7 years) with STEMI, were measured at the bedside by using a simple point-of-care test in a 15-minute period before PCI. Follow-up up to 42 days was performed. RESULTS: A baseline BNP value of 331 pg/mL had a sensitivity of 87.9% and a specificity of 90% for predicting death in a follow-up study. There was no difference in subgroups by median BNP (100 pg/mL) in Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 before PCI, although higher BNP levels were observed among patients with TIMI <3 after PCI than among those with TIMI 3 (356.7 +/- 350.8 vs 144.9 +/- 191.2 pg/mL; P <.0001). In multivariate logistic regression analysis, admission BNP was the independent predictor for the following: death (odds ratio [OR], 16.3; 95% confidence interval [CI], 1.4 to 186.7; P =.03), TIMI grade <3 after PCI (OR, 3.4; 95% CI, 1.2 to 9.6; P =.02), and the no-reflow phenomenon (OR, 6.2; 95% CI, 1.7 to 23; P =.007) after adjusting for other variables. CONCLUSIONS: BNP levels obtained on admission are a powerful, independent predictor of short-term death and angiographic success after PCI in patients with STEMI. The no-reflow phenomenon may be predicted in STEMI on the basis of high serum BNP values on admission.
BACKGROUND:B-type natriuretic peptide (BNP) levels are predictive of short-term death in patients with acute coronary syndromes. Few data are available for BNP levels obtained on admission in patients with acute ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: Blood samples for BNP estimation, obtained on admission in 126 consecutive patients (mean age, 58.8 +/- 10.7 years) with STEMI, were measured at the bedside by using a simple point-of-care test in a 15-minute period before PCI. Follow-up up to 42 days was performed. RESULTS: A baseline BNP value of 331 pg/mL had a sensitivity of 87.9% and a specificity of 90% for predicting death in a follow-up study. There was no difference in subgroups by median BNP (100 pg/mL) in Thrombolysis In Myocardial Infarction (TIMI) flow grade 3 before PCI, although higher BNP levels were observed among patients with TIMI <3 after PCI than among those with TIMI 3 (356.7 +/- 350.8 vs 144.9 +/- 191.2 pg/mL; P <.0001). In multivariate logistic regression analysis, admission BNP was the independent predictor for the following: death (odds ratio [OR], 16.3; 95% confidence interval [CI], 1.4 to 186.7; P =.03), TIMI grade <3 after PCI (OR, 3.4; 95% CI, 1.2 to 9.6; P =.02), and the no-reflow phenomenon (OR, 6.2; 95% CI, 1.7 to 23; P =.007) after adjusting for other variables. CONCLUSIONS:BNP levels obtained on admission are a powerful, independent predictor of short-term death and angiographic success after PCI in patients with STEMI. The no-reflow phenomenon may be predicted in STEMI on the basis of high serum BNP values on admission.
Authors: Sean van Diepen; Matthew T Roe; Renato D Lopes; Amanda Stebbins; Stefan James; L Kristin Newby; David J Moliterno; Franz-Josef Neumann; Justin A Ezekowitz; Kenneth W Mahaffey; Judith S Hochman; Christian W Hamm; Paul W Armstrong; Pierre Theroux; Christopher B Granger Journal: J Thromb Thrombolysis Date: 2012-07 Impact factor: 2.300
Authors: Amanda A Fox; Jochen D Muehlschlegel; Simon C Body; Stanton K Shernan; Kuang-Yu Liu; Tjorvi E Perry; Sary F Aranki; E Francis Cook; Edward R Marcantonio; Charles D Collard Journal: Anesthesiology Date: 2010-04 Impact factor: 7.892
Authors: O Akgul; H Uyarel; H Pusuroglu; N Isiksacan; S Turen; M Erturk; O Surgit; O Celik; E Oner; A Birant; I F Akturk; N Uslu Journal: Herz Date: 2014-06 Impact factor: 1.443
Authors: Amanda A Fox; Edward R Marcantonio; Charles D Collard; Mathis Thoma; Tjorvi E Perry; Stanton K Shernan; Jochen D Muehlschlegel; Simon C Body Journal: Anesthesiology Date: 2011-04 Impact factor: 7.892