Long Zhang1, Yi Hao2. 1. Department of Cardiology, Beijing Luhe Hospital, Capital Medical University Beijing, China. 2. Department of Cardiac Surgery, Beijing Luhe Hospital, Capital Medical University Beijing, China.
Abstract
OBJECTIVE: To explore the correlation of the peripheral blood NT-proBNP and NF-κB p65 expression levels in the peripheral blood with the myocardial infarct areas on the admission and post-treatment no-reflow of acute myocardial infarction patients. METHODS: A total of 124 acute myocardial infarction patients treated in our hospital were placed in an acute myocardial infarction group, 115 patients with stable coronary heart disease were placed in a coronary heart disease group, and 121 healthy people undergoing routine physical examinations were placed in a healthy examination group. After the treatment, the myocardial infarction patients were divided into grade I, grade II, grade III, and grade IV groups according to their Killip heart function classifications. The patients were divided into reflow (thrombolysis in myocardial infarction (TIMI) > grade 2) and no-reflow (TIMI ≤ grade 2) groups according to their flow grades, and into single branch, double branch, and multi-branch groups according to each patient's number of diseased coronary vessels. The Wagner scale scores were used to estimate the infarct areas. All the patients were divided into small area, medium area, and large area groups according to the score results or into good prognosis and poor prognosis groups according to the presence or absence of complications. The amino-terminal pro-brain natriuretic peptide (NT-proBNP) and the nuclear factor-kappa B p65 (NF-κB p65) expression levels in the peripheral blood among the groups were compared. RESULTS: The NT-proBNP and NF-κB p65 expression levels in the peripheral blood were significantly lower in the physical examination and coronary heart disease groups than they were in the acute myocardial infarction group (P<0.001) and were the lowest in the physical examination group (P<0.05). The expression levels were the lowest in the grade I group according to their Killip heart function classification (P<0.001) and increased gradually in each of the grade I to IV groups (all P<0.001). The expression levels were lowest in the single branch group and highest in the multi-branch group (P<0.001). The expression levels were lower in the no-reflow group than they were in the reflow group (P<0.001). The expression levels increased in the large area group compared with the small area and medium area groups (P<0.001). The expression levels were higher in the poor prognosis group than in the good prognosis group (P<0.001). CONCLUSION: Patients with high peripheral blood NT-proBNP and NF-κB expression levels had increased myocardial infarct areas. The peripheral blood NT-proBNP and NF-κB levels increased in the patients with post-treatment reflow. Therefore, the NT-proBNP and NF-κB expression levels can be used as important indicators for predicting the severity and prognoses of acute myocardial infarction patients. AJTR
OBJECTIVE: To explore the correlation of the peripheral blood NT-proBNP and NF-κB p65 expression levels in the peripheral blood with the myocardial infarct areas on the admission and post-treatment no-reflow of acute myocardial infarctionpatients. METHODS: A total of 124 acute myocardial infarctionpatients treated in our hospital were placed in an acute myocardial infarction group, 115 patients with stable coronary heart disease were placed in a coronary heart disease group, and 121 healthy people undergoing routine physical examinations were placed in a healthy examination group. After the treatment, the myocardial infarctionpatients were divided into grade I, grade II, grade III, and grade IV groups according to their Killip heart function classifications. The patients were divided into reflow (thrombolysis in myocardial infarction (TIMI) > grade 2) and no-reflow (TIMI ≤ grade 2) groups according to their flow grades, and into single branch, double branch, and multi-branch groups according to each patient's number of diseased coronary vessels. The Wagner scale scores were used to estimate the infarct areas. All the patients were divided into small area, medium area, and large area groups according to the score results or into good prognosis and poor prognosis groups according to the presence or absence of complications. The amino-terminal pro-brain natriuretic peptide (NT-proBNP) and the nuclear factor-kappa B p65 (NF-κB p65) expression levels in the peripheral blood among the groups were compared. RESULTS: The NT-proBNP and NF-κB p65 expression levels in the peripheral blood were significantly lower in the physical examination and coronary heart disease groups than they were in the acute myocardial infarction group (P<0.001) and were the lowest in the physical examination group (P<0.05). The expression levels were the lowest in the grade I group according to their Killip heart function classification (P<0.001) and increased gradually in each of the grade I to IV groups (all P<0.001). The expression levels were lowest in the single branch group and highest in the multi-branch group (P<0.001). The expression levels were lower in the no-reflow group than they were in the reflow group (P<0.001). The expression levels increased in the large area group compared with the small area and medium area groups (P<0.001). The expression levels were higher in the poor prognosis group than in the good prognosis group (P<0.001). CONCLUSION:Patients with high peripheral blood NT-proBNP and NF-κB expression levels had increased myocardial infarct areas. The peripheral blood NT-proBNP and NF-κB levels increased in the patients with post-treatment reflow. Therefore, the NT-proBNP and NF-κB expression levels can be used as important indicators for predicting the severity and prognoses of acute myocardial infarctionpatients. AJTR
Authors: Robin Hofmann; Stefan K James; Tomas Jernberg; Bertil Lindahl; David Erlinge; Nils Witt; Gabriel Arefalk; Mats Frick; Joakim Alfredsson; Lennart Nilsson; Annica Ravn-Fischer; Elmir Omerovic; Thomas Kellerth; David Sparv; Ulf Ekelund; Rickard Linder; Mattias Ekström; Jörg Lauermann; Urban Haaga; John Pernow; Ollie Östlund; Johan Herlitz; Leif Svensson Journal: N Engl J Med Date: 2017-08-28 Impact factor: 91.245
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