The Value of NT-proBNP in Prediction of the Clinical Prognosis of Patients with STEAMI after Emergent PCI

Objective To evaluate the value of N-terminal pro-brain natriureticpeptide in prediction of the long-term prognosis of patients with acute ST elevation myocardial infarction(STEM)I after emergent PCI.Methods The plasm levels of NT-proBNP were detected with ELISA method in 106 patients with STEMI in our Hospital at 24 h,72 h,7 d,and 30 d after admission.The patients were also given echocardiography at 24 h,72 h,7 d,and 30d after admission to detect the LVEDVI,LVESVI and LVEF.The patients were followed up for 6 months to observe the incidence of cardiac events(death,cardiac shock and congestive heart failure).Then the patients were divided into two groups: Group 1 with cardiac events(28 cases) and Group2 without cardiac events(78 cases).Results Compared with patients in group 2,the plasm levels NT-proBNP were significantly higher than in group 1(1972.4±742.6 vs.896.7±517.3,P 0.05).The optimal cutoff value of NT-proBNP to predict cardiac event was 860 fmol/mL,with a sensitivity of 88.3% and a specificity of 70.1%.Patients with NT-proBNP concentration above 860 fmol/mL had a higher rate of cardiac events(heart failure,cardiogenic shock and death)(43.47% vs.13.33%,P 0.05).The areas under ROC curve of NT-proBNP and LVEDD to predict cardiac event were 0.801 and 0.476.Only NT-proBNP had predictive values for the patients(P0.01).Univariate analysis showed that NT-proBNP was correlated with the cardiac events(r=0.8017,P0.01).Multiple regression logistic analysis showed that NT-proBNP was an independent factor for prediction of cardiac events(P=0.012,95% confidence interval of 1.869-4.127).Conclusions The emergent percutaneous coronary intervention can decrease NT-proBNP levels,reduce LVRM and improve LVEF.NT-proBNP can predict the long term prognosis of STEMI patients.