| Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial. | |
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MedLine Citation:
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PMID: 22307842 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Coronary plaque rupture is associated with a systemic inflammatory response. The relationship between baseline N-terminal pro B-type natriuretic peptide (NT-proBNP), a prognostic marker in patients with acute coronary syndromes, and systemic inflammatory mediators in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) is not well described. Of 5,745 STEMI patients treated with primary PCI in the APEX-AMI trial, we evaluated the relationship between baseline NT-proBNP levels and baseline levels of inflammatory markers and markers of myonecrosis in a subset of 772 who were enrolled in a biomarker substudy. Spearman correlations (r (s)) were calculated between baseline NT-proBNP levels and a panel of ten systemic inflammatory biomarkers. Interleukin (IL)-6, a pro-inflammatory cytokine, was significantly positively correlated with NT-proBNP (r (s) = 0.317, P < 0.001). In a sensitivity analysis excluding all heart failure patients, the correlation between baseline IL-6 and NT-proBNP remained significant (n = 651, r (s) = 0.296, P < 0.001). A positive association was also observed with high sensitivity C-reactive protein (r (s) = 0.377, P < 0.001) and there was a weak negative correlation with the anti-inflammatory cytokine IL-10 (r (s) = -0.109, P = 0.003). No other significant correlations were observed among the other testes inflammatory cytokines and chemokines. In STEMI patients undergoing primary PCI, the pro-inflammatory cytokine IL-6 was modestly correlated with baseline NT-proBNP levels. This relationship remained significant in patients without heart failure. This finding is consistent with pre-clinical and clinical research suggesting that systemic inflammation may influence NT-proBNP expression independently of myocardial stretch. |
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Authors:
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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 |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-2-4 |
Journal Detail:
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Title: Journal of thrombosis and thrombolysis Volume: - ISSN: 1573-742X ISO Abbreviation: - Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-2-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9502018 Medline TA: J Thromb Thrombolysis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Duke Clinical Research Institute, Duke University Medical Center, North Pavilion, 2400 Pratt Street, Durham, NC, 27705, USA, sean.van.diepen@duke.edu. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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