Evaluacija prognostičkih markera srčane insuficijencije pacijenata tretiranih perkutanom koronarnom intervencijom nakon akutnog infarkta miokarda
Sažetak
Background / Aim: The concentration of N-terminal brain natrium peptides (NT-proBNP) is an important marker within the diagnostic and prognostic analysis of patients with chronic heart failure. In patients with ST-segment elevation myocardial infarction, natriuretic peptides are dominant predictors of death, heart failure and additional myocardial infarctions. The aim of this study was to correlate prognostic markers of heart failure following acute myocardial infarction.
Methods: 193 patients with myocardial infarction were divided into two groups: 69 patients with NT-proBNP ≤ 1000 pg/mL and 124 patients with NT-proBNP > 1000 pg/mL. During the hospitalisation, laboratory data, clinical data and information on previous medications were collected. Echocardiography was used to identify left ventricular ejection fraction (LVEF). All statistical analysis were done in SPSS, version 23.
Results: The group with elevated NT-proBNP (> 1000 pg/mL) was older (p < 0.001) and suffered more often of arterial hypertension (p = 0.04) and atrial fibrillation (p = 0.003). Heart rate was higher and LVEF was lower in patients with elevated NT-proBNP values (p < 0.001). Mean LVEF in the 193 patients was 46.86 %. In both linear and binary logistic regression analysis multiple predictors of elevated NT-proBNP have been identified.
Conclusion: Increased ranges of NT-proBNP in patients following acute myocardial infarction are in correlation with decreased LVEF, elevated high-sensitive troponin I, lactate dehydrogenase, urea, creatinine, C-reactive peptides. This may guide clinicians to assess and treat early stages of heart failure.
Reference
Jernberg T, James S, Lindahl B, Johnston N, Stridsberg M, Venge P, et al. Natriuretic peptides in unstable coronary artery disease. Eur Heart J 2004 Sep;25(17):1486-93.
Wiviott SD, de Lemos JA, Morrow DA. Pathophysiology, prognostic significance and clinical utility of B-type natriuretic peptide in acute coronary syndromes. Clin Chim Acta 2004 Aug 16;346(2):119-28.
Richards AM, Nicholls MG, Espiner EA, Lainchbury JG, Troughton RW, Elliott J, et al. B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction. Circulation 2003 Jun 10;107(22):2786-92.
Vanderheyden M, Bartunek J, Goethals M. Brain and other natriuretic peptides: molecular aspects. Eur J Heart Fail 2004 Mar 15;6(3):261-8.
Palazzuoli A, Deckers J, Calabrò A, Campagna MS, Nuti R, Pastorelli M, et al. Brain natriuretic peptide and other risk markers for outcome assessment in patients with non-ST-elevation coronary syndromes and preserved systolic function. Am J Cardiol 2006 Nov 15;98(10):1322-8.
Chenevier-Gobeaux C, Claessens YE, Voyer S, Desmoulins D, Ekindjian OG. Influence of renal function on N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients admitted for dyspnoea in the Emergency Department: comparison with brain natriuretic peptide (BNP). Clin Chim Acta 2005 Nov;361(1-2):167-75.
Vickery S, Price CP, John RI, Abbas NA, Webb MC, Kempson ME, et al. B-type natriuretic peptide (BNP) and amino-terminal proBNP in patients with CKD: relationship to renal function and left ventricular hypertrophy. Am J Kidney Dis 2005 Oct;46(4):610-20.
Ribeiro AL. Natriuretic peptides in elderly people with acute myocardial infarction. BMJ 2009 May 6;338:b787. doi: 10.1136/bmj.b787.
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