Serum NT-proBNP on admission can predict ST-segment resolution in patients with acute myocardial infarction after primary percutaneous coronary intervention

Abstract

Objective: The aim of this study was to investigate the value of initial serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations in ST-segment elevation myocardial infarction (STEMI) patients for predicting ST-segment resolution (STR) after primary percutaneous coronary intervention (pPCI).

Patients and methods: Consecutive STEMI patients (n = 218) who underwent pPCI were assigned to an STR group (≥ 50 % resolution) or a non-STR group (< 50 % resolution). All patients were followed up for 12 months, and major adverse cardiac events were recorded. Data related to the pPCI procedure, biochemical parameters, and cardiac markers were compared between the two groups. Predictive factors of non-STR were also identified.

Results: STR at 180 min after pPCI occurred in 202 patients (92.7 %). Compared to the STR group, patients in the non-STR group had a significantly lower left ventricular ejection fraction, a larger left ventricular end-diastolic dimension, and significantly higher serum concentrations of glycosylated hemoglobin and NT-proBNP. Multivariate logistic regression analysis indicated that a high serum NT-proBNP level in STEMI patients on hospital admission was the only independent predictive factor of non-STR after pPCI. An NT-proBNP concentration of ≥ 2,563.6 pg/ml had a sensitivity of 81.2 % and a specificity of 65.8 %.

Conclusions: Serum NT-proBNP concentrations in STEMI patients on hospital admission were useful in predicting non-STR after pPCI.

Keywords: Acute myocardial infarction; Myocardial reperfusion; N-terminal pro-brain natriuretic peptide; Primary percutaneous coronary intervention; ST-segment resolution.