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Serum N-terminal pro-B-type natriuretic peptide levels at the time of hospital admission predict of microvascular obstructions after primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.
- Source :
-
Journal of interventional cardiology [J Interv Cardiol] 2011 Feb; Vol. 24 (1), pp. 34-41. Date of Electronic Publication: 2010 Dec 27. - Publication Year :
- 2011
-
Abstract
- Background: Significant microvascular obstruction (MVO) during primary percutaneous coronary intervention (PCI) may suggest severe myocardial damage. The predictive value of N-terminal pro-B-type natriuretic peptide levels (NT-proBNP) for MVO has not been previously evaluated.<br />Hypothesis: The purpose of the study was to determine whether NT-proBNP levels measured upon hospital admission of ST-segment elevation myocardial infarction (STEMI) patients receiving primary PCI have predictive value for MVO.<br />Methods: NT-proBNP levels were obtained upon admission to the emergency department, for 41 acute STEMI patients. Cardiac contrast-enhanced magnetic resonance imaging (CE-MRI) was performed within 4 days after PCI. The optimal cut-off value to predict grade 3 MVO was determined using a receiver operating characteristic (ROC) curve. Multivariate regression analysis was performed to determine predictors for grade 3 MVO.<br />Results: MVO grade correlated with left ventricular ejection fraction (LVEF; r =-0.383, P = 0.013), peak serum creatine kinase MB iso-enzyme (CK-MB; r = 0.470, P = 0.002), and NT-proBNP levels (r = 0.357, P = 0.022). The optimal cut-off value to predict grade 3 MVO was an NT-proBNP level of ≥80 pg/mL. Multivariate regression analysis, including LVEF, peak CK-MB, and an NT-proBNP ≥80 pg/mL revealed that only an NT-proBNP ≥80 pg/mL was an independent factor related to grade 3 MVO.<br />Conclusion: NT-proBNP levels upon hospital admission have a predictive value for MVOs. Further study is needed to determine if protective treatment strategies are warranted in STEMI patients with high NT-proBNP levels at presentation.<br /> (©2010, Wiley Periodicals, Inc.)
- Subjects :
- Biomarkers
Contrast Media
Coronary Angiography
Female
Health Status Indicators
Humans
Magnetic Resonance Imaging methods
Male
Middle Aged
Myocardial Infarction pathology
Myocardial Infarction therapy
Prognosis
Prospective Studies
Republic of Korea
Statistics as Topic
Stroke Volume
Time Factors
Ventricular Function, Left
Angioplasty, Balloon, Coronary statistics & numerical data
Hospitalization statistics & numerical data
Microvessels pathology
Myocardial Infarction blood
Natriuretic Peptide, Brain blood
Peptide Fragments blood
Subjects
Details
- Language :
- English
- ISSN :
- 1540-8183
- Volume :
- 24
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Journal of interventional cardiology
- Publication Type :
- Academic Journal
- Accession number :
- 21198848
- Full Text :
- https://doi.org/10.1111/j.1540-8183.2010.00606.x