N-Terminal Pro-Brain Natriuretic Peptide is a Biomarker of Congestive Heart Failure and Predictive of 30-Day Untoward Clinical Outcomes in Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

スポンサーリンク

概要

• 論文の詳細を見る

• Background Increased levels of N-terminal pro-brain natiuretic peptide (NT-proBNP) are now recognized as a new and useful biochemical marker that is predictive of clinical outcomes in patients with congestive heart failure (CHF). However, an association between an increased circulating level of this biomarker and clinical outcomes in patients following acute myocardial infarction (AMI) has not been fully delineated. Thus, the purpose of this study was to test whether NT-proBNP can predict prognosis in patients following ST-segment elevated AMI. Methods and Results A prospective cohort study of 242 consecutive patients with ST-segment elevated AMI of onset <12h who underwent primary percutaneous coronary intervention (PCI) was conducted. Blood samples for plasma concentration of NT-proBNP were collected following vascular puncture. Univariate analysis demonstrated that the 30-day composite major adverse clinical outcomes (MACO) [advanced Killip score ≥3, functional class ≥3 of CHF and 30-day mortality] were strongly associated with elevated NT-proBNP (>243pg/ml) (p<0.0001), unsuccessful reperfusion (final thrombolysis in myocardial infarction flow ≤2) (p<0.0001), left ventricular ejection fraction (LVEF) <45% (p<0.0001), diabetes mellitus (DM) (p=0.0004) and multivessel disease (p=0.0005). Multiple stepwise logistic regression analysis demonstrated that elevation of NT-proBNP (p=0.0002), LVEF <45% (p=0.0003), DM (p=0.0007), unsuccessful reperfusion (p=0.006), and age (≥70 years) (p=0.031) are independent predictors of 30-day MACO. Additionally, elevation of NT-proBNP, together with advanced Killip score and unsuccessful reperfusion, are significant independent predictors of increased 30-day mortality (all p values <0.005). Conclusion Increased NT-proBNP level was the most independent predictor of 30-day MACO in patients with ST-segment elevated AMI undergoing primary PCI.

• 社団法人日本循環器学会の論文
• 2006-01-20

著者

• Wu Chiung

  Division Of Cardiology Chang Gung Memorial Hospital

• Yip Hon

  Division Of Cardiology Chang Gung Memorial Hospital

• Chen Yen

  Division Of Cardiology Chang Gung Memorial Hospital

• Hung Wei

  Division Of Cardiology Chang Gung Memorial Hospital

• Yang Cheng

  Division Of Cardiology Chang Gung Memorial Hospital

• Chang Hsueh

  Department of Biological Sciences, National Sun Yat-Sen University

• Su Cheng

  Department of Clinical Pathology, Chang Gung Memorial Hospital

• Chang Hsueh

  Department Of Biological Sciences National Sun Yat-sen University

• Su Cheng

  Department Of Clinical Pathology Chang Gung Memorial Hospital

関連論文

• N-Terminal Pro-Brain Natriuretic Peptide is a Biomarker of Congestive Heart Failure and Predictive of 30-Day Untoward Clinical Outcomes in Patients With Acute Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention
• Serial Changes in Platelet Activation in Patients With Unstable Angina Following Coronary Stenting : Evaluation of the Effect of Clopidogrel Loading Dose in Inhibiting Platelet Activation
• Serial Changes in Circulating Concentrations of Soluble CD40 Ligand and C-Reactive Protein in Patients With Unstable Angina Undergoing Coronary Stenting : Role of Inflammatory Mediators in Predicting Late Restenosis
• Primary Percutaneous Coronary Intervention Lowers the Incidence of Ischemic Mitral Regurgitation in Patients With Acute ST-Elevated Myocardial Infarction
• Serum Concentrations of High-Sensitivity C-Reactive Protein Predict Progressively Obstructive Lesions Rather Than Late Restenosis in Patients With Unstable Angina Undergoing Coronary Artery Stenting

スポンサーリンク