Source:http://linkedlifedata.com/resource/pubmed/id/17487257
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| Predicate | Object |
|---|---|
| rdf:type | |
| lifeskim:mentions | |
| pubmed:issue |
1
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| pubmed:dateCreated |
2007-5-9
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| pubmed:abstractText |
While baseline N-terminal brain natriuretic peptide (NT-proBNP) is useful in the prognosis of acute ST-elevation myocardial infarction (STEMI), it is unclear whether a relationship exists between serial NT-proBNP, reperfusion success, and prognosis. We prospectively defined a NT-proBNP analysis in the WEST (Which Early ST-elevation myocardial infarction Therapy) trial that enrolled 304 acute STEMI patients. NT-proBNP (pg/mL) was measured at baseline prior to treatment (n=258) and 72 to 96 h (n=247) and 30 days (n=221) after treatment (Delta NT-proBNP=72 h value - the baseline NT-proBNP). Reperfusion success was measured by ST-segment resolution at 180 min, infarct size by peak creatine kinase (CK) during the first 24 h, and QRS score at discharge (QRSd). The primary endpoint was a 30 day clinical composite. The ability of either baseline NT-proBNP or Delta NT-proBNP to predict the primary endpoint was compared using single-variable logistic regression and the c-statistic. Median (interquartile range) NT-proBNP in pg/mL was 87 (39-316) at baseline, 864 (338-1857) at 72 h, and 585 (264-1212) at 30 days. ST resolution was inversely correlated with Delta NT-proBNP (r=-0.23, p=0.002) and 30 day NT-proBNP (30 day NT-proBNP 1016, 828, and 397 for <30%, 30%-70%, >or=70% STR, respectively, p<0.001). Infarct size was correlated with Delta NT-proBNP by CK (r=0.41, p<0.001) and QRSd (r=0.31, p<0.001); the 30 day NT-proBNP relationship was similar for CK (r=0.48, p<0.001) and QRSd (p=0.003). The baseline NT-proBNP was associated with an increased 30-day composite endpoint (Q1, 19%; Q2, 20%; Q3, 15%; Q4, 38%; p=0.03 for trend) as was Delta NT-proBNP (Q1, 16%; Q2, 18%; Q3, 19%; Q4, 37%; p=0.009 for trend). The c-statistic for baseline, 72 to 96 h, and Delta NT-proBNP was 0.59, 0.61, and 0.62 for the 30-day composite and 0.64, 0.62, and 0.62 for the 90-day composite, respectively. Delta NT-proBNP clearly predicts short-term adverse cardiac events and is superior to baseline NT-proBNP, but similar to the 72 to 96 h NT-proBNP in predicting clinical events after STEMI. This likely reflects the variability in NT-proBNP at presentation and the ability to integrate subsequent important physiologic sequelae of STEMI such as reperfusion and infarct size.
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| pubmed:language |
eng
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| pubmed:journal | |
| pubmed:citationSubset |
IM
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| pubmed:chemical |
http://linkedlifedata.com/resource/pubmed/chemical/Biological Markers,
http://linkedlifedata.com/resource/pubmed/chemical/C-Reactive Protein,
http://linkedlifedata.com/resource/pubmed/chemical/Fibrinolytic Agents,
http://linkedlifedata.com/resource/pubmed/chemical/Natriuretic Peptide, Brain,
http://linkedlifedata.com/resource/pubmed/chemical/Peptide Fragments,
http://linkedlifedata.com/resource/pubmed/chemical/Tissue Plasminogen Activator,
http://linkedlifedata.com/resource/pubmed/chemical/pro-brain natriuretic peptide (1-76),
http://linkedlifedata.com/resource/pubmed/chemical/tenecteplase
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| pubmed:status |
MEDLINE
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| pubmed:month |
Jan
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| pubmed:issn |
0008-4212
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| pubmed:author | |
| pubmed:issnType |
Print
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| pubmed:volume |
85
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| pubmed:owner |
NLM
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| pubmed:authorsComplete |
Y
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| pubmed:pagination |
173-8
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| pubmed:dateRevised |
2010-11-18
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| pubmed:meshHeading |
pubmed-meshheading:17487257-Aged,
pubmed-meshheading:17487257-Angioplasty, Balloon, Coronary,
pubmed-meshheading:17487257-Biological Markers,
pubmed-meshheading:17487257-C-Reactive Protein,
pubmed-meshheading:17487257-Coronary Circulation,
pubmed-meshheading:17487257-Female,
pubmed-meshheading:17487257-Fibrinolytic Agents,
pubmed-meshheading:17487257-Humans,
pubmed-meshheading:17487257-Male,
pubmed-meshheading:17487257-Middle Aged,
pubmed-meshheading:17487257-Myocardial Infarction,
pubmed-meshheading:17487257-Myocardial Reperfusion,
pubmed-meshheading:17487257-Natriuretic Peptide, Brain,
pubmed-meshheading:17487257-Odds Ratio,
pubmed-meshheading:17487257-Peptide Fragments,
pubmed-meshheading:17487257-Predictive Value of Tests,
pubmed-meshheading:17487257-Prognosis,
pubmed-meshheading:17487257-Prospective Studies,
pubmed-meshheading:17487257-Research Design,
pubmed-meshheading:17487257-Risk Assessment,
pubmed-meshheading:17487257-Time Factors,
pubmed-meshheading:17487257-Tissue Plasminogen Activator,
pubmed-meshheading:17487257-Treatment Outcome
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| pubmed:year |
2007
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| pubmed:articleTitle |
Insights into the change in brain natriuretic peptide after ST-elevation myocardial infarction (STEMI): why should it be better than baseline?
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| pubmed:affiliation |
2C2 Cardiology UAH, University of Alberta, 8440-112 Street, Edmonton, AB T6G 2B7, Canada. justin.ezekowitz@ualberta.ca
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| pubmed:publicationType |
Journal Article,
Randomized Controlled Trial,
Research Support, Non-U.S. Gov't
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