Comparison of Usefulness of N-Terminal Pro-Brain Natriuretic Peptide as an Independent Predictor of Cardiac Function Among Admission Cardiac Serum Biomarkers in Patients With Anterior Wall Versus Nonanterior Wall ST-Segment Elevation Myocardial Infarction

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• 作者：Joost D.E. Haeck MDp>ap>p> ; p>p>j.d.haeck@amc.uva.nl"" rel=""nofollowp> ; Niels J.W. Verouden MDp>ap> ; Wichert J. Kuijt MDp>ap>p> ; p>p>cp> ; Karel T. Koch MD ; PhDp>ap> ; Jan P. Van Straalen MScp>bp> ; Johan Fischer PhDp>bp> ; Maarten Groenink MD ; PhDp>ap> ; Luc Bilodeau MDp>dp> ; Jan G.P. Tijssen PhDp>ap> ; Mitchell W. Krucoff MDp>cp> ; Robbert J. De Winter MD ; PhDp>ap>
• 刊名：The American Journal of Cardiology
• 出版年：2010
• 出版时间：15 April 2010
• 年：2010
• 卷：105
• 期：8
• 页码：1065-1069
• 全文大小：245 K

文摘

The purpose of the present study was to determine the prognostic value of N-terminal pro-brain natriuretic peptide (NT-pro-BNP), among other serum biomarkers, on cardiac magnetic resonance (CMR) imaging parameters of cardiac function and infarct size in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. We measured NT-pro-BNP, cardiac troponin T, creatinine kinase-MB fraction, high-sensitivity C-reactive protein, and creatinine on the patients' arrival at the catheterization laboratory in 206 patients with ST-segment elevation myocardial infarction. The NT-pro-BNP levels were divided into quartiles and correlated with left ventricular function and infarct size measured by CMR imaging at 4 to 6 months. Compared to the lower quartiles, patients with nonanterior wall myocardial infarction in the highest quartile of NT-pro-BNP (≥260 pg/ml) more often had a greater left ventricular end-systolic volume (68 vs 39 ml/mp>2p>, p <0.001), a lower left ventricular ejection fraction (42 % vs 54 % , p <0.001), a larger infarct size (9 vs 4 g/mp>2p>, p = 0.002), and a larger number of transmural segments (11 % of segments vs 3 % of segments, p <0.001). Multivariate analysis revealed that a NT-pro-BNP level of ≥260 pg/ml was the strongest independent predictor of left ventricular ejection fraction in patients with nonanterior wall myocardial infarction compared to the other serum biomarkers (β = −5.8; p = 0.019). In conclusion, in patients with nonanterior wall myocardial infarction undergoing primary percutaneous coronary intervention, an admission NT-pro-BNP level of ≥260 pg/ml was a strong, independent predictor of left ventricular function assessed by CMR imaging at follow-up. Our findings suggest that NT-pro-BNP, a widely available biomarker, might be helpful in the early risk stratification of patients with nonanterior wall myocardial infarction.