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The value of acute versus sub-acute BNP measurements for the prediction of long-term mortality after first ST-elevation myocardial

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Author(s): Agnieszka M. Tycińska | Anna Lisowska | Robert Sawicki | Bożena Sobkowicz | Anna Kozieradzka | Karol Kamiński | Barbara Mroczko | Włodzimierz J. Musiał | Sławomir Dobrzycki | Maciej Szmitkowski

Journal: Polish Journal of Cardiology
ISSN 1507-5540

Volume: 13;
Issue: 4;
Start page: 213;
Date: 2011;
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Keywords: BNP | STEMI | mortality | |

ABSTRACT
Aim of the study: We aimed to compare prognostic value of B-type natriuretic peptide (BNP) concentration obtained on admission and 5th day in patients with first ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Material and methods: In 211 patients with first STEMI, plasma BNP concentrations were measured twice: on admission and later - on 5th day of hospitalization. Left ventricle ejection fraction (LVEF) was assessed in echocardiography within 24 hours. Patients were followed for a median of 48.2 months (range 42.3-72.6). The analyzed end-point was total survival: data concerning mortality was obtained from the local population registry. Results: During follow-up 20.4% (n=43) patients died. Patients who died were significantly older, had lower baseline systolic blood pressure values, higher Killip class as well as higher TIMI Risk Score for STEMI. During 5 days interval median plasma BNP level significantly increased (p156.15 pg/mL (for both p=0.04). Patients who exceeded both indicated BNP values had the least long-term survival (p=0.016). Conclusions: In patients with first STEMI treated with pPCI, BNP obtained in acute and sub-acute phase are predictive for long-term mortality, however different cut-off values are indicative. The presence of increased BNP concentrations determined bath on admission and on day 5 identifies the patients with the worst prognosis.
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