N-terminal probrain natriuretic peptide predicts adverse outcomes in acute-myocardial infarction even with preserved left ventricular ejection fraction.
dc.contributor.author | Puri, Aniket | en_US |
dc.contributor.author | Narain, Varun S | en_US |
dc.contributor.author | Mehrotra, Sanjay | en_US |
dc.contributor.author | Dwivedi, Sudhanshu K | en_US |
dc.contributor.author | Saran, Ram K | en_US |
dc.contributor.author | Puri, Vijay K | en_US |
dc.date.accessioned | 2006-03-08 | en_US |
dc.date.accessioned | 2009-05-27T04:20:19Z | |
dc.date.available | 2006-03-08 | en_US |
dc.date.available | 2009-05-27T04:20:19Z | |
dc.date.issued | 2006-03-08 | en_US |
dc.description.abstract | BACKGROUND: Risk stratification of patients with acute myocardial infarction is based on various clinical, biochemical or electrocardiographic parameters. There is emerging evidence that N-terminal probrain natriuretic peptides (NT-proBNP) possess characteristics of an ideal biomarker. In this study we looked into the role of NT-proBNP in risk stratification and prediction of short-term events in patients presenting with acute myocardial infarction (MI) and having preserved left ventricular functions as assessed by ejection fraction (EF) on echocardiography. METHODS AND RESULTS: Of a total of 250 consecutive patients admitted with a diagnosis of acute ST segment elevation myocardial infarction, 84 patients were found to have ejection fraction greater than 50% (44 with anterior MI, 40 with inferior MI. Serum NT-proBNP was measured using electrochemiluminiscence assay (Roche). On two-dimensional echocardiography, modified Simpson's technique was used to measure the EF. Follow-up at day 30 included a two-dimensional echocardiography and assessment for worsening heart failure, recurrent ischemia, and repeat hospitalization. Death due to cardiovascular cause by 30 days was also noted. The mean value of NT-proBNP for those having EF over 50% was 1542.38 + 4649.12 pg/ml. For the purpose of a dichotomous analysis, the median value was determined (907.5 pg/ml). In patients having NT-proBNP above median, the Killip class was expectedly higher 1.62 + 0.21 vs 1.0 + 0.12 ( p< 0.05) and the thrombolysis in myocardial infarction scores were worse (4.77 + 1.56 vs 2.71 + 1.11, p < 0.05). The ejection fraction was similar (59.72 + 8.8 vs 58.76 + 6.9, p= NS) in the two groups. At 30 days followup, patients having NT-proBNP above median showed a further decline in the Killip class and EF. The clinical outcomes (composite of recurrent ischemia, worsening heart failure and repeat hospitalization) were also worse in this group ( p< 0.05). CONCLUSION: In patients with apparently normal ejection fraction and without left ventricular dysfunction, a higher NT-proBNP level would suggest poorer short-term clinical outcomes and would require a more aggressive treatment strategy. | en_US |
dc.description.affiliation | Department of Cardiology, King George Medical University, Lucknow. aniket1@sancharnet.in | en_US |
dc.identifier.citation | Puri A, Narain VS, Mehrotra S, Dwivedi SK, Saran RK, Puri VK. N-terminal probrain natriuretic peptide predicts adverse outcomes in acute-myocardial infarction even with preserved left ventricular ejection fraction. Indian Heart Journal. 2006 Mar-Apr; 58(2): 138-43 | en_US |
dc.identifier.uri | https://imsear.searo.who.int/handle/123456789/3709 | |
dc.language.iso | eng | en_US |
dc.source.uri | https://indianheartjournal.com | en_US |
dc.subject.mesh | Aged | en_US |
dc.subject.mesh | Biological Markers --blood | en_US |
dc.subject.mesh | Female | en_US |
dc.subject.mesh | Humans | en_US |
dc.subject.mesh | Male | en_US |
dc.subject.mesh | Middle Aged | en_US |
dc.subject.mesh | Myocardial Infarction --blood | en_US |
dc.subject.mesh | Natriuretic Peptide, Brain --blood | en_US |
dc.subject.mesh | Peptide Fragments --blood | en_US |
dc.subject.mesh | Predictive Value of Tests | en_US |
dc.subject.mesh | Risk Assessment | en_US |
dc.subject.mesh | Stroke Volume | en_US |
dc.subject.mesh | Ventricular Function, Left | en_US |
dc.title | N-terminal probrain natriuretic peptide predicts adverse outcomes in acute-myocardial infarction even with preserved left ventricular ejection fraction. | en_US |
dc.type | Journal Article | en_US |
Files
License bundle
1 - 1 of 1