STUDY ON VALUE OF PLASMA NT-proBNP LEVEL IN PREDICTING LEFT VENTRICULAR SYSTOLIC DYSFUNTION IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION
Main Article Content
Abstract
Background: Heart failure is a common complication in patients with acute myocardial infarction. The serum NT-proBNP is not only a biomarker reflecting the strong cardiac response after an infarction but also a tool for diagnosing heart failure after acute myocardial infarction. Objectives: To survey the value of serum NT-proBNP concentration in predicting left ventricular systolic dysfuntion in patients with acute myocardial infarction. Materials and methods: Crosssectional descriptive study on 145 patients with acute myocardial infarction treated at Can Tho Central General Hospital in 2018-2020. NT-proBNP levels were quantified by electrochemical luminescent immunoassay (ECLIA) within 24-72 hours after the onset of angina, identifying NTproBNP cut-off points to predict heart failure with reduced ejection fraction (EF ≤40%) after acute myocardial infarction. Results: The NT-proBNP concentration median value was 1348 pg/mL (5 - >35000); the median values of NT-proBNP increased by age group (p<0.001); serum NT-proBNP levels increased with Killip class at admission (Killip I: 1111 pg/mL, Killip II: 6175 pg/mL, Killip III, IV: 6856 pg/mL, p<0.001); serum NT-proBNP concentration among groups according to left ventricular ejection fraction, preservation (EF ≥50%) was 935.7 pg/mL, mid range (41-49%) was 2396.5 pg/mL, reduction (EF ≤40%) was 4372.5 pg/mL. NT-proBNP concentration was negatively correlated with ejection fraction (r=-0,345; p<0.001). The cut-off value of NT-proBNP concentration that helped to predict heart failure with reduced ejection fraction (EF ≤40%) after acute MI was >1363 pg/mL, sensitivity was 77.8% and specificity was 59.6% (AUC=0.701; p <0.05). Conclusions: The serum NT-proBNP concentration at admission helps to predict left ventricular systolic dysfuntion, especially heart failure with reduced ejection fraction in patients with acute myocardial infarction.
Article Details
Keywords
heart failure, acute myocardial infarction, plasma NT-proBNP
References
2. Trần Thái Hà, Phạm Nguyên Sơn (2010), “Đánh giá biến thiên nhịp tim ở các bệnh nhân sau nhồi máu cơ tim được can thiệp động mạch vành thì đầu”, Tạp chí Tim Mạch Học Việt Nam, số 56, tr 45-52.
3. Nguyễn Thị Thu Phượng, Hồ Huỳnh Quang Trí (2015), “Nghiên cứu giá trị tiên lượng tử vong của NT-proBNP ở bệnh nhân hội chứng vành cấp”, Tạp chí Tim Mạch Học Việt Nam, số 70, tr 30-36.
4. C. Siva Sankara (2015), “Prognostic significance of NT-proBNP, 3D LA volume and LV dyssynchrony in patients with acute STEMI undergoing primary percutaneous intervention”, Indian Heart Journal.
5. Gang Wang, Haibo Gu (2016), “Diagnostic value of serum NT-proBNP level in predicting short-term outcomes in diabetic patients with acute coronary syndrome after PCI”, Int J Clin Exp Med 2016; 9 (2), p 4575-4580.
6. Kudret Keskin et al (2019), “Thẹ relationship between myocardial viability and plasma NTproBNP levels”, Journal of Human Rhythm 2019, 5 (3), p 246-255.
7. L.Logis et al (2009), “Prognostic value of N-terminal pro-brain natriuretic peptide in elderly people with acute myocardial infarction: prospective observational study”, BMJ, p 1-6.
8. Mrinal Kunj et al (2017), “N-Terminal Pro-Brain Natriuretic Peptide as a Predictor of Complication and Mortality in Acute ST Segment Elevation Myocardial Infarction”, International Journal of Contemporary Medical Research, p 1100-1103.
9. Nahid Salehi et al (2016), “Effect of Percutaneous Coronary Intervention on Left Ventricular Diastolic Function in Patients with Coronary Artery Disease”, Global Journal of Health Science; Vol. 8, No. 1.
10. Sikora-Frac Malgorzata (2019), “Improvement of Left Ventricular Function After Percutaneous Coronary Intervention in Patients with Stable Coronary Artery Disease and
Preserved Ejection Fraction: Impact of Diabetes Mellitus”, Cardiology journal.
11. Wojciech Drewnial et al (2015), “Prognostic Significance of NT-proBNP Levels in Patients over 65 Presenting Acute Myocardial Infarction Treated Invasively or Conservatively”, BioMed Research International.