N-terminal probrain natriuretic peptide as a predictor of short-term outcomes in acute myocardial infarction.

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dc.contributor.authorPuri, Aniketen_US
dc.contributor.authorNarain, Varun Sen_US
dc.contributor.authorMehrotra, Sanjayen_US
dc.contributor.authorDwivedi, Sudhanshu Ken_US
dc.contributor.authorSaran, Ram Ken_US
dc.contributor.authorPuri, Vijay Ken_US
dc.date.accessioned2005-07-15en_US
dc.date.accessioned2009-05-27T04:24:29Z
dc.date.available2005-07-15en_US
dc.date.available2009-05-27T04:24:29Z
dc.date.issued2005-07-15en_US
dc.description.abstractBACKGROUND: Risk stratification and prediction of high risk for mortality in patients with acute coronary syndromes is based on clinical evaluation, electrocardiogram, biochemical markers and various risk assessment scores. There is emerging evidence that N-terminal probrain natriuretic peptide possesses several characteristics of an ideal biomarker. In this study we looked into the role of N-terminal probrain natriuretic peptide in risk stratification and prediction of short-term events including mortality in patients presenting with acute coronary syndrome. METHODS AND RESULTS: A total of 120 consecutive patients admitted with a diagnosis of acute myocardial infarction, including both ST elevation myocardial infarction (n=80) and non-ST elevation myocardial infarction (n=40) were enrolled. Serum N-terminal probrain natriuretic peptide was measured using electrochemiluminiscence assay (Roche Diagnostics), on the Elecsys 2010 system. On two-dimentional echocardiography, modified Simpson's technique was used to measure the ejection fraction along with end-systolic volume. Various other demographic variables, echocardiographic parameters and risk scores were also assessed. Follow-up at day 30 included a two-dimentional echocardiographic evaluation 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 N-terminal probrain natriuretic peptide for the whole cohort was 2307 +/- 2287 pg/ml (271.4 +/- 269.1 pmol/L). For the purpose of comparative analysis, the median value was determined [1403 pg/ml (165 pmol/L)]. In patients having N-terminal probrain natriuretic peptide above median, the end-systolic volume was higher while ejection fraction was significantly lower at baseline (p<0.05). At 30 days follow-up, there was a further decline in ejection fraction from 47.7 +/- 11.4 to 43.9 +/- 9.9 (p<0.05), and clinical outcomes were worse in this group. There was a 5% mortality in the entire study group and all patients who died had N-terminal probrain natriuretic peptide above median. On multivariate logistic regression analysis, N-terminal probrain natriuretic peptide above median (OR=32.79, 95% CI 8.74-123.1, p<0.001) emerged as the strongest predictors of adverse outcomes, including 30-day mortality (p<0.001). CONCLUSIONS: N-terminal probrain natriuretic peptide emerged as a strong prognostic tool across the spectrum of acute myocardial infarction and had the strongest predictive value for short-term adverse outcomes including death.en_US
dc.description.affiliationDepartment of Cardiology, King George Medical University, Lucknow. aniket1@sancharnet.inen_US
dc.identifier.citationPuri A, Narain VS, Mehrotra S, Dwivedi SK, Saran RK, Puri VK. N-terminal probrain natriuretic peptide as a predictor of short-term outcomes in acute myocardial infarction. Indian Heart Journal. 2005 Jul-Aug; 57(4): 304-10en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/4775
dc.language.isoengen_US
dc.source.urihttps://indianheartjournal.comen_US
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshBiological Markers --blooden_US
dc.subject.meshFemaleen_US
dc.subject.meshHumansen_US
dc.subject.meshLogistic Modelsen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshMyocardial Infarction --blooden_US
dc.subject.meshNatriuretic Peptide, Brain --blooden_US
dc.subject.meshPeptide Fragments --blooden_US
dc.subject.meshPrognosisen_US
dc.subject.meshProtein Precursors --blooden_US
dc.subject.meshRisk Assessmenten_US
dc.titleN-terminal probrain natriuretic peptide as a predictor of short-term outcomes in acute myocardial infarction.en_US
dc.typeJournal Articleen_US
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