The change and meaning of plasma B type natriuretic peptide level in acute myocardial infarction patients after emergency percutaneous coronary interention

Objective To observe the change of plasma B type natriuretic peptide( BNP) level in acute myocardial infarction patients after emergency percutaneous coronary interention( PCI),and analyze the relationship between it and left ventricular remodeling( LVRM),prognosis. Methods Choose 112 cases of hospitalized patients with initial AMI,all underwent PCI,infarction related artery( IRA) opened in 69 cases( opened group),did not open in 43 cases( not opened group). On admission to detect myocardial injury markers [CK,CK-MB,troponin I( cTnI) ],to measure left ventricular ejection fraction( LVEF),left ventricular end-diastolic volume index( LVEDVI) on the seventh day of admission by using ultrasound. To measure the level of BNP in plasma on admission,24 hours after AMI,the seventh day of admission( marked them as BNP1,BNP2,BNP3 respectively); Postoperative follow-up of 2 years,recording the occurrence of major adverse cardiovascular events( MACE). Results Comparing serum level of CK,CK-MB,cTnI,TG,LDL-Cin two groups on admission,P 0. 05; 7 days after admission,the level of LVEF in comparing opened group was higher than not openedgroup( P 0. 05),BNP1 had no statistically significant differences between the two groups,BNP2 increased significantly more than BNP1,BNP3( P 0. 05),the level of BNP2,BNP3 increased significantly in opened group than not opened group( P 0. 01). BNP had positive correlation with LVEDVI,CK,CK-Mb and cTnI,and negatively related with LVEF in three time points detection( P 0. 01). There were 10 MACE cases in opened group,16 cases in not opened group,P 0. 01; The area under the ROC curve of BNP2 predicting MACE within 2 years was 0. 791,P 0. 05; the boundary value of 332 ng / L,sensitivity of MACE prediction was 76. 9%,specificity was 73. 3%. Conclusions The level of BNP in AMI patients after PCI is higher,the change is helpful to judge open case of IRA; The BNP level in AMI patients 24 h after PCI can predict MACE,help to understand LVRM earlier,to prevent or slow down the occurrence and development of heart failure after AMI.