Document Detail

Clinical significance of brain natriuretic peptide in patients with postmyocardial infarction.
MedLine Citation:
PMID:  11129679     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Risk stratification after acute myocardial infarction (AMI) includes the evaluation of left ventricular (LV) function. Natriuretic peptides, and particularly brain natriuretic peptide (BNP), emerged as a potential marker of ventricular function and prognosis after AMI. HYPOTHESIS: Brain natriuretic peptide levels are related to ventricular function, either systolic or isolated diastolic, and can give prognostic information in patients surviving AMI. METHODS: In all, 101 patients were enrolled. An echocardiographic (M-mode, two-dimensional, and pulsed Doppler) evaluation was performed and blood samples for BNP measurement were obtained. Clinical events were recorded during 12 months of follow-up. RESULTS: A negative correlation between BNP and LV ejection fraction was observed (r = -0.38; p < 0.001). The BNP levels were higher among patients with LV systolic dysfunction than in patients with isolated diastolic dysfunction (339.1 +/- 249.9 vs. 168.0 +/- 110.5 pg/ml, p = 0.001). The latter had higher levels of BNP than those with normal LV function (68.3 +/- 72.6 pg/ml, p < 0.001). The BNP accuracy to detect LV systolic dysfunction was good (area under the ROC curve [AUC] = 0.83) and increased when isolated diastolic dysfunction was also considered (AUC = 0.87). Brain natriuretic peptide had a very good accuracy in the prediction of death (AUC = 0.95) and the development of heart failure (AUC = 0.90). CONCLUSION: These results extend previous evidence relating BNP to systolic function after AMI. Furthermore, a relationship between BNP levels and diastolic function was found. Brain natriuretic peptide had a very good performance in detecting the occurrence of an adverse event. We conclude that BNP can detect high-risk patients and help select patients for more aggressive approaches.
P Bettencourt; A Ferreira; N Pardal-Oliveira; M Pereira; C Queirós; V Araújo; M Cerqueira-Gomes; M J Maciel
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  23     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2000 Dec 
Date Detail:
Created Date:  2000-12-20     Completed Date:  2001-03-01     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  921-7     Citation Subset:  IM    
Hospital S. João, and Faculdade de Medicina da Universidade do Porto, Portugal.
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MeSH Terms
Diastole / physiology
Middle Aged
Myocardial Infarction / blood*,  physiopathology
Natriuretic Peptide, Brain / analysis*
ROC Curve
Risk Assessment
Sensitivity and Specificity
Ventricular Dysfunction, Left / diagnosis*
Reg. No./Substance:
114471-18-0/Natriuretic Peptide, Brain

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