|
|
The predictive value of plasma BNP for recent ventricular remodeling in patients with acute ST-segment elevation myocardial infarction after primary percutaneous coronary intervention |
DENG Lili1, TIAN Zhiyu1, ZHAO Wenping2, WANG Yanfei2, and GAO Shuxian2 |
1.Department of Cardiovascular Medicine,Characteristic Medical Center of Chinese People’s Armed Police Force,Tianjin 300162,China; 2.Department of Cardiovascular Medicine, Affiliated Hospital of Hebei University, Baoding 071000, China |
|
|
Abstract Objective To investigate the predictive value of brain natriuretic peptide (BNP) levels for ventricular remodeling six months after primary percutaneous coronary intervention (p-PCI) in patients with acute myocardial infarction(AMI).Methods One hundred patients with acute ST segment elevation myocardial infarction (STEMI) were selected as the subjects, who had been treated with primary percutaneous coronary intervention (p-PCI) within 12 h of onset. The BNP levels were measured 24 hours after chest pain onset. The left ventricular end diastolic volume(LVEDV) was measured via echocardiography at the 7th day and 6th month after PCI. According to the results of echocardiography, the rate of increase of the left ventricular end diastolic volume was calculated:△LVEDV%=(the 6th month LVEDV-the 7th day LVEDV)/the 7th day LVEDV ×100%. Based on this rate of increase, all the patients were divided into the ventricular remodeling group(△LVEDV>20%,n=28)and non-remodeling group(△LVEDV<20%,n=72). The receiver operating characteristic (ROC) curve was drawn to investigate the predictive value of BNP levels 24 hour after onset for ventricular remodeling within 6 months.Results The area under the ROC curve of BNP levels 24 hours after onset was 0.844 when used to predict ventricular remodeling within 6 months,P<0.05. The cut-off value was 357.0 pg/ml, sensitivity of ventricular remodeling prediction was 75.0%, and specificity was 81.9%.Conclusions The significant increase of BNP levels in plasma 24 hours after the onset of acute myocardial infarction is an important risk factor for recent left ventricular remodeling in patients, which can help predict the occurrence of recent left ventricular remodeling.
|
Received: 20 March 2019
|
|
|
|
|
[1] |
毕 莹, 刘新林, 刘小伟, 等. 曲美他嗪对急性前壁心肌梗死心肌缺血再灌注损伤的保护作用[J]. 武警医学, 2017,28(10):988-991.
|
[2] |
Ryabova T R, Sokolov A A, Dudko V A, et al. Dynamics of left ventricular remodeling in patients with acute myocardial infarction[J]. Kardiologiia,2002,42(9):30-34.
|
[3] |
Maisel A S, Koon J, Krishnaswamy P, et al. Utility of B-natriuretic peptide as a rapid, point-of-care test for screening patients undergoing echocardiography to determine left ventricular dysfunction[J]. Am Heart J, 2001,141(3):367-374.
|
[4] |
Lin S, Yokoyama H, Rac V E, et al. Novel biomarkers in diagnosing cardiac ischemia in the emergency department: a systematic review[J]. Resuscitation, 2012,83(6):684-691.
|
[5] |
Cannon C P, Greenberg B H. Risk stratification and prognostic factors in the post-myocardial infarction patient[J]. Am J Cardiol, 2008,102(5A):13-20.
|
[6] |
Inoue T, Sakuma M, Yaguchi I, et al. Early recanalization and plasma brain natriuretic peptide as an indicator of left ventricular function after acute myocardial infarction[J]. Am Heart J, 2002,143(5):790-796.
|
[7] |
Oduncu V, Erkol A, Tanalp A C, et al. In-hospital prognostic value of admission plasma B-type natriuretic peptide levels in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction[J]. Turk Kardiyol Dern Ars, 2011, 39(7):540-548.
|
[8] |
Eggers K M, Lagerqvist B, Venge P, et al. Prognostic value of biomarkers during and after non-ST-segment elevation acute coronary syndrome [J]. J Am Coll Cardiol, 2009,54(4):357-364.
|
[9] |
Richards A M, Nicholls M G, Espiner E A, et al. B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction[J]. Circulation, 2003,107(22):2786-2792.
|
[10] |
陶辉宇, 孙 翔, 周小华. 急性心肌梗死患者脑钠素的时空变化与患者预后的关系及PCI治疗对其影响[J]. 中国医药指南, 2015, 20 (1):91-92.
|
[11] |
黄开建, 翁春发. 冠脉介入治疗对急性心梗患者脑利钠肽、醛固酮水平和近期预后的作用探讨[J]. 中国现代医生, 2018,56(16):16-18,22.
|
[12] |
Bassan R, Potsch A, Maisel A, et al. B-type natriuretic peptide: a novel early blood marker of acute myocardial infarction in patients with chest pain and no ST-segment elevation[J]. Eur Heart J, 2005, 26(3):234-240.
|
[13] |
Morita E, Yasue H, Yoshimura M, et al. Increased plasma levels of brain natriuretic peptide in patients with acute myocardial infarction[J]. Circulation, 1993,88(1):82-91.
|
[14] |
Arakawa N, Nakamura M, Aoki H, et al. Relationship between plasma level of brain natriuretic peptide and myocardial infarct size[J]. Cardiology, 1994,85(5):334-340.
|
[15] |
张茹艳, 赵 茹, 宋衍秋, 等. 急性心肌梗死患者急诊PCI术后血浆B型钠尿肽水平变化及意义[J]. 山东医药,2014,54(4): 1-3,6.
|
[16] |
Magga J, Puhakka M, Hietakorpi S, et al. Atrial natriuretic peptide, B-type natriuretic peptide, and serum collagen markers after acute myocardial infarction[J]. J Appl Physiol (1985), 2004,96(4):1306-1311.
|
[17] |
Wilkins M R, Redondo J, Brown L A. The natriuretic-peptide family[J]. Lancet, 1997,349(9061):1307-1310.
|
|
|
|