The role of measurement and changing levels of NT-proBNP in patients with first ST-elevation myocardial infarction treated with primary coronary angioplasty

Introduction: Thelevelsofnatriureticpeptides(BNPandNT-proBNP)changeduringtheperiodafteronsetofmyocardial infarction (MI). Theirconcentrationreflectstheseverityofleftventricular(LV)dysfunctionandis usefulmarker for risk stratificationofmortalityafterMI,butthevaluesofnatriureticpeptideslevelsandtheirchanginginpatients with MI treated with primary angioplasty is still a query. Material and methods: We analysed 111 consecutive patients with acute MI treated with primary angioplasty. NT-proBNP levels were measured on admission and 4-5th day of MI (on discharge). In further analysis the patients with LV systolic dysfunction definedasejectionfraction(EF)<55% were included in study group and the others were the control group. Results: Mean serum NT-proBNP level was significallyhigherinstudygroup(onadmissionandonthe4-5thdayofMI).Multivariateanalysisrevealedthattimefrom the onset of chest pain to angioplasty and EF/WMSI were independently associated with serum NT-proBNP level >105 pg/ml (median) on the firstdayofMI.OnlyEF,WMSIandevolutionofnon-Qmyocardialinfarctioncorrelatedindependently with NT-proBNP >388,5 pg/ml (median) measured on discharge from the hospital. Conclusions: 1. NT-proBNP concentration changes during the period afteronsetofMIandinmajorityofpatientsthepeptide’slevelsriseon 4-5th day in comparison to level on admission. 2. NT-proBNP levels are significallyhigherinpatientswithsystolicLV dysfunction and this correlation is observed on admission and 4-5 day afterMI.3.SerumNT-proBNPconcentration independently correlates with echocardiographic parameters of LV systolic function. (Clin Exp Med Lett 2007; 48(1):65-71)

Keywords: primary angioplasty, NT-proBNP, leftventriculardysfunction