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255 PRO-B-TYPE NATRIURETIC PEPTIDE IN ST-ELEVATION MYOCARDIAL INFARCTION: CORRELATION WITH TRADITIONAL MARKERS AND INDICATOR OF LONG-TERM LEFT VENTRICULAR DYSFUNCTION.
  1. D. Godkar,
  2. A. Gupta,
  3. K. Juliard,
  4. S. Niranjan,
  5. R. Cucco,
  6. A. Khanna
  1. Department of Internal Medicine, Coney Island Hospital, Brooklyn, NY

Abstract

Background The circulating peptide, pro-B-type natriuretic peptide (pro-BNP) was examined for prediction of cardiac function and prognosis and compared with previously reported markers [cardiac troponin I (cTnI) and creatine phosphokinase (CPK)] in patients with ST-elevation myocardial infarction (STEMI).

Methods and Results We examined plasma levels of pro-BNP, cTnI, and CPK in 84 patients presenting with STEMI. Patients presenting with KILLIP's class 3 and 4, renal failure, and a previous history of low ejection fraction (EF) were excluded. EF was determined by echocardiography 6 months after STEMI. Of the 84 patients in this study, 60 (71%) were male and 24 (29%) female. Their ages ranged from 43 to 88 yr, with a mean of 63.6 yr (SD 13.0 yr). The correlation between pro-BNP and CPK was excellent (r=.88, p < .001), while the following correlations were on the borderline of fair to moderate: pro- BNP and cTnI (r = .52, p < .001) and cTnI and CPK (r = .50, p < .001). Left ventricular ejection fraction at 6 months was moderately negatively correlated with peak CPK (r = 2.64, p < .001) and pro-BNP (r = 2.66, p < .001); its negative correlation with cTnI (r = 2.47, p < .001) was only fair.

Conclusions We conclude that increased concentrations of pro-BNP at initial presentation of patients with STEMI correlate well with levels of CPK and the may reflect long-term left ventricular dysfunction in these patients. These data support the value of combining markers of hemodynamic stress with traditional approaches to risk assessment in acute myocardial infarction.

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