The Early Changing Pattern of the B-Type Natriuretic Peptide Concentration and its Significance as a Prognostic Marker after Acute Myocardial Infarction.
10.4070/kcj.2006.36.7.526
- Author:
Hyunmin CHOE
1
;
Byung Su YOO
;
Ho Yeol RYU
;
Sang Baek KOH
;
Sei Jin CHANG
;
Sung Oh HWANG
;
Jang Young KIM
;
Seung Whan LEE
;
Junghan YOON
;
Kyung Hoon CHOE
Author Information
1. Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea. yubs@yonsei.ac.kr
- Publication Type:Original Article
- Keywords:
B-type natriuretic peptide;
Myocardial infarction;
Prognosis
- MeSH:
Demography;
Humans;
Male;
Myocardial Infarction*;
Natriuretic Peptide, Brain*;
Prognosis;
Risk Factors;
ROC Curve;
Survival Rate
- From:Korean Circulation Journal
2006;36(7):526-534
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: The BNP concentration varies considerably after the onset of AMI, and this makes it difficult to determine the right time to measure the BNP as a valid prognostic marker. The aim of this study was to examine the early changing patterns of BNP and to decide on the suitable time for measuring the BNP as a prognostic marker after the onset of AMI. SUBJECTS AND METHODS: From Feb 2002 to May 2005, we analyzed the changing patterns of BNP in 321 AMI patients. BNP (Triage(R)) was measured at the acute phase (< or = 24 hr), the early phase (2 to 6 day), the late phase (1 to 4 week) & the long-term phase (>4 week) after the onset of AMI. The end points were major adverse cardiac events (MACE) and cardiovascular death (CVD). RESULTS: The mean BNP was 306.2+/-802.8 at the acute phase (mean: 9.5 hours), 251.9+/-592.8 at the early phase (mean: 5.1 days), 103.1+/-172.9 at the late phase (mean: 26.8 days) and 179.7+/-353.3 pg/mL at the long-term phase (mean: 45.9 days). There were no significant differences of the demographic factors between the MACE and Non-MACE group. Multivariative analysis showed that early phase BNP (p=0.007) and male gender (p=0.009) were significant risk factors for MACE. The early phase BNP (p=0.037) and age (p=0.022) were the significant risk factors of CVD. On the ROC curve, the early phase BNP for predicting the CVD risk was 186 pg/mL (AUC=0.87, p<0.001). The Kaplan-Meier survival curve showed that the survival rate was higher for the patients with an early phase BNP<186 pg/mL than it was for those patients with a BNP> or = 186 pg/mL (p=0.000). CONCLUSION: The early levels or changing patterns of the BNP concentrations following AMI showed different patterns of change depending on several prognostic factors. The early phase (2 to 6 day) BNP concentration after the onset of AMI could be used as a significant prognostic marker.
