Prognostic Value of NT-PROBNPin Acute St Elevation Myocardial Infarction who Underwent Primary Percutaneous Coronary Intervention

Background: Previous clinical studies have demonstrated that natriuretic peptide values are independent predictors of mortality and heart failure in acute coronary syndrome.
Aim: To correlate the outcome with the level of NT-proBNP taken on admission, among patients in acute ST elevation myocardial infarction (STEMI) who underwent successful revascularisation.
Method: The study involved 148 patients who presented with acute STEMI within 12 hours, and underwent successful primary PCI. Data was collected on baseline characteristics, and NT-proBNP level on admission. Echocardiogram results and outcome at 1 year follow up was documented.
Result: The NT-proBNP taken on admission showed 99(67%) patients had a normal NT-proBNP 300pg/ml. Patient with elevated NT-proBNP level >300pg/ml had lower left ventricular ejection fraction (LVEF) (40 +/- 10 vs 46 +/- 10, p <0.001) and higher incidence of multiple vessel disease (57% vs 37%, p> 0.023). From logistic regression analysis, the odd ratios indicates that patients with NT-proBNP>300pg/mL are 3.25 times more likely to have impaired LVEF when compared to those with NT-proBNP level <300pg/mL (OR 3.25, 95% CI 1.56 to 6.74, p=0.002). Higher total ischaemic time was also associated with higher NT-proBNP (p< 0.001). There were no differences in length of stay, heart failure, recurrent acute coronary syndrome and mortality within 1 year.
Conclusion: The study suggests that elevated baseline NT-proBNP level in patients with acute STEMI who underwent successful primary PCI is associated with reduce left ventricular ejection fraction but NT-proBNP level does not predict heart failure and mortality within 1 year.