ISSN 1016-5169 | E-ISSN 1308-4488
Archives of the Turkish Society of Cardiology
In-hospital prognostic value of admission plasma B-type natriuretic peptide levels in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2011; 39(7): 540-548 | DOI: 10.5543/tkda.2011.01610

In-hospital prognostic value of admission plasma B-type natriuretic peptide levels in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction

Vecih Oduncu1, Ayhan Erkol2, Ali Cevat Tanalp3, Cihan Dündar1, İbrahim Halil Tanboga4, Dicle Sırma5, Ali Karagöz1, Can Yücel Karabay1, Akın İzgi1, Selçuk Pala1, Kürşat Tigen1, Cevat Kırma1
1Department of Cardiology, Kartal Kosuyolu Heart Education And Research Hospital, Istanbul, Turkey
2Department of Cardiology, Kocaeli Derince Education And Research Hospital, Kocaeli, Turkey
3Department of Cardiology, Medicana International Hospital, Ankara, Turkey
4Department of Cardiology, Erzurum Education And Research Hospital, Erzurum, Turkey
5Department of Cardiology, Siirt State Hospital, Siirt, Turkey


OBJECTIVES
We assessed in-hospital prognostic value of admission plasma B-type natriuretic peptide (BNP) levels in patients undergoing primary percutaneous coronary intervention (p-PCI) for acute ST-elevation myocardial infarction (STEMI).

STUDY DESIGN
In a retrospective design, we evaluated 992 patients (801 males, 191 females; mean age 56±12 years) treated with p-PCI for STEMI. The patients were divided into two groups according to the admission BNP levels, taking the cut-off value of BNP as 100 pg/ml; i.e, ≥100 pg/ml (n=334, 33.7%) and <100 pg/ml (n=658, 66.3%). Postprocedural angiographic and clinical in-hospital results were recorded.

RESULTS
No-reflow (24% vs. 9%), heart failure (32.3% vs. 5.5%) and death (15.6% vs. 1.7%) were significantly more common in patients with BNP ≥100 pg/ml (p<0.001). In multivariate analysis, elevated baseline BNP level was identified as an independent predictor of no-reflow (OR=1.83; 95% CI 1.22-2.74, p=0.003), acute heart failure (OR=2.67; 95% CI 1.55-4.58, p<0.001), and in-hospital mortality (OR=3.28; 95% CI 1.51-7.14, p=0.003). In receiver operating characteristic curve analysis, the area under the curve and sensitivity/specificity of the cut-off value of BNP (100 pg/ml) for prediction of clinical endpoints were 0.741 and 58.6%/70.3% for no-reflow, 0.822 and 75%/73.3% for heart failure, and 0.833 and 82.5%/69.4% for death, respectively (p<0.001 for all).

CONCLUSION
Elevated admission BNP level is an independent predictor of angiographic no-reflow, acute heart failure, and mortality in STEMI patients during in-hospital period, suggesting that it might be incorporated into traditional risk scoring systems to improve early risk stratification.

Keywords: Angioplasty, balloon, coronary, coronary angiography; myocardial infarction; natriuretic peptide, brain; prognosis; risk assessment

How to cite this article
Vecih Oduncu, Ayhan Erkol, Ali Cevat Tanalp, Cihan Dündar, İbrahim Halil Tanboga, Dicle Sırma, Ali Karagöz, Can Yücel Karabay, Akın İzgi, Selçuk Pala, Kürşat Tigen, Cevat Kırma. In-hospital prognostic value of admission plasma B-type natriuretic peptide levels in patients undergoing primary angioplasty for acute ST-elevation myocardial infarction. Turk Kardiyol Dern Ars. 2011; 39(7): 540-548

Corresponding Author: Vecih Oduncu, Türkiye
Manuscript Language: English


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