scholarly journals N-terminal pro-brain natriuretic peptide improves the C-ACS risk score prediction of clinical outcomes in patients with ST-elevation myocardial infarction

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Peng-cheng He ◽  
Chong-yang Duan ◽  
Yuan-hui Liu ◽  
Xue-biao Wei ◽  
Shu-guang Lin
Keyword(s):  
Myocardial Infarction ◽  
Brain Natriuretic Peptide ◽  
Clinical Outcomes ◽  
Natriuretic Peptide ◽  
Risk Score ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

scholarly journals A Study of N-terminal pro-Brain Natriuretic Peptide as a Predictor of Adverse Outcome of STEMI

2016 ◽  
Vol 11 (1) ◽  
pp. 13-17
Author(s):  
Mohammad Zakir Hossain ◽  
Md Abu Siddique ◽  
Tanjima Parveen ◽  
Manzoor Mahmood ◽  
Khandaker Aisha Siddika ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Troponin I ◽  
Adverse Outcome ◽  
Venous Blood ◽  
St Elevation Myocardial Infarction ◽  
Prognostic Information ◽  
Prediction Of Mortality ◽  
St Elevation

Background: Mortality risk is quite variable among fibrinolytic treated ST elevation myocardial infarction patients. Careful and early risk evaluation of each patient is therefore important. Until now, the most evaluated biomarker has been troponin I on admission, which gives strong prognostic information. NT pro BNP has shown reasonable promise in predicting the adverse outcome of STEMI. This research will provide the information regarding its efficacy as a predictor of adverse outcome following STEMI. Objective: To assess the prognostic value of N-terminal pro-brain natriuretic peptide in fibrinolytic treated ST elevation myocardial infarction (STEMI) patients. Method: This short term prospective study was done in Cardiology dept. of BSMMU. We valuated 115 patients of STEMI admitted within 12 hours and receiving thrombolytic therapy. Venous blood sample was collected for NT pro BNP before starting fibrinolytic therapy. Additional clinical data was recorded including detailed complications of STEMI. Results: Out of 115 patients of STEMI 32.2% patient had adverse outcome among them 9.6% patients died, heart failure 13.0%, cardiogenic shock 7.8%, VT & VF 5.2%, acute MR 2.6%, VSR 0.9%, CHB 2.6% and 67.8% patient had no adverse outcome. According to association between hospital outcomes with N-terminal pro BNP level, it was observed that the mean Nterminal pro BNP level was higher in adverse outcome group. Based on the receiver-operator characteristic (ROC) curves N-Terminal Pro BNP level gave a cut off value ?480.0 pg/ml, with 88.5% sensitivity and 100.0% specificity for prediction of complications and similarly N-terminal pro BNP level gave a cut off value ?725.5 pg/ml, with 72.7% sensitivity and 93.3% specificity for prediction of mortality. Conclusion: N-Terminal Pro BNP level was highly sensitive and very much effective in the evaluation of adverse outcome of fibrinolytic treated ST elevation myocardial infarction (STEMI).University Heart Journal Vol. 11, No. 1, January 2015; 13-17

scholarly journals Biomarkers predictive of late cardiogenic shock development in patients with suspected ST-elevation myocardial infarction

2020 ◽  
Vol 9 (6) ◽  
pp. 557-566 ◽  
Author(s):  
Martin Frydland ◽  
Jacob E Møller ◽  
Matias G Lindholm ◽  
Rikke Hansen ◽  
Sebastian Wiberg ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Atrial Natriuretic Peptide ◽  
Cardiogenic Shock ◽  
Hospital Admission ◽  
Natriuretic Peptide ◽  
Risk Score ◽  
St Elevation Myocardial Infarction ◽  
Neurohormonal Activation ◽  
St Elevation ◽  
Atrial Natriuretic

Background: Cardiogenic shock complicating ST-elevation myocardial infarction is characterised by progressive left ventricular dysfunction causing inflammation and neurohormonal activation. Often, cardiogenic shock develops after hospital admission. Whether inflammation and a neurohormonal activation precede development of clinical cardiogenic shock is unknown. Methods and results: In 93% of 2247 consecutive patients with suspected ST-elevation myocardial infarction admitted at two tertiary heart centres, admission plasma levels of pro-atrial natriuretic peptide, copeptin, mid-regional pro-adrenomedullin and stimulation-2 were measured on hospital admission. Patients were stratified according to no cardiogenic shock development and cardiogenic shock developed before (early cardiogenic shock) or after (late cardiogenic shock) leaving the catheterization laboratory. In total, 225 (10%) patients developed cardiogenic shock, amongst these patients late cardiogenic shock occurred in 64 (2.9%). All four biomarkers were independently associated with the development of late cardiogenic shock (odds ratio per two-fold increase in risk: 1.19–3.13) even when adjusted for the recently developed Observatoire Régional Breton sur l’Infarctus risk score for prediction of late cardiogenic shock development. Furthermore, pro-atrial natriuretic peptide, copeptin and mid-regional pro-adrenomedullin, but not stimulation-2, added significant predictive information, when added to the Observatoire Régional Breton sur l’Infarctus risk score (area under the receiver-operating characteristic curve, pro-atrial natriuretic peptide: 0.87, p=0.0008; copeptin: 0.86, p<0.05; mid-regional pro-adrenomedullin: 0.88, p=0.006). Conclusions: Pro-atrial natriuretic peptide, copeptin, mid-regional pro-adrenomedullin and stimulation-2 admission plasma concentration were associated with late cardiogenic shock development in patients admitted with suspected ST-elevation myocardial infarction. Pro-atrial natriuretic peptide, mid-regional pro-adrenomedullin and copeptin had independent predictive value for late cardiogenic shock development.

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