Document Detail

In-hospital prognostic value of admission plasma B-type natriuretic peptide levels in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction.
MedLine Citation:
PMID:  21983763     Owner:  NLM     Status:  In-Data-Review    
OBJECTIVES: We assessed in-hospital prognostic value of admission plasma B-type natriuretic peptide (BNP) levels in patients undergoing primary percutaneous coronary intervention (p-PCI) for acute ST-elevation myocardial infarction (STEMI).
STUDY DESIGN: In a retrospective design, we evaluated 992 patients (801 males, 191 females; mean age 56±12 years) treated with p-PCI for STEMI. The patients were divided into two groups according to the admission BNP levels, taking the cut-off value of BNP as 100 pg/ml; i.e, ≥100 pg/ml (n=334, 33.7%) and <100 pg/ml (n=658, 66.3%). Postprocedural angiographic and clinical in-hospital results were recorded.
RESULTS: No-reflow (24% vs. 9%), heart failure (32.3% vs. 5.5%) and death (15.6% vs. 1.7%) were significantly more common in patients with BNP ≥100 pg/ml (p<0.001). In multivariate analysis, elevated baseline BNP level was identified as an independent predictor of no-reflow (OR=1.83; 95% CI 1.22-2.74, p=0.003), acute heart failure (OR=2.67; 95% CI 1.55-4.58, p<0.001), and in-hospital mortality (OR=3.28; 95% CI 1.51-7.14, p=0.003). In receiver operating characteristic curve analysis, the area under the curve and sensitivity/specificity of the cut-off value of BNP (100 pg/ml) for prediction of clinical endpoints were 0.741 and 58.6%/70.3% for no-reflow, 0.822 and 75%/73.3% for heart failure, and 0.833 and 82.5%/69.4% for death, respectively (p<0.001 for all).
CONCLUSION: Elevated admission BNP level is an independent predictor of angiographic no-reflow, acute heart failure, and mortality in STEMI patients during in-hospital period, suggesting that it might be incorporated into traditional risk scoring systems to improve early risk stratification.
Vecih Oduncu; Ayhan Erkol; Ali Cevat Tanalp; Cihan Dündar; Ibrahim Halil Tanboğa; Dicle Sırma; Ali Karagöz; Can Yücel Karabay; Akın Izgi; Selçuk Pala; Kürşat Tigen; Cevat Kırma
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Türk Kardiyoloji Derneği arşivi : Türk Kardiyoloji Derneğinin yayın organıdır     Volume:  39     ISSN:  1016-5169     ISO Abbreviation:  Turk Kardiyol Dern Ars     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9426239     Medline TA:  Turk Kardiyol Dern Ars     Country:  Turkey    
Other Details:
Languages:  eng     Pagination:  540-8     Citation Subset:  IM    
Department of Cardiology, Kartal Koşuyolu Heart and Research Hospital, İstanbul, Turkey.
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