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  • Title: Plasma B-type natriuretic peptide level can predict myocardial tissue perfusion in patients undergoing primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction.
    Author: Seo SM, Kim S, Chang K, Min J, Kim TH, Koh YS, Park HJ, Shin WS, Lee JM, Kim PJ, Chung WS, Seung KB.
    Journal: Coron Artery Dis; 2011; 22(6):405-10. PubMed ID: 21701385.
    Abstract:
    BACKGROUND: Inadequate myocardial tissue perfusion after successful revascularization in ST-segment elevation myocardial infarction (STEMI) is associated with worse clinical outcomes. We investigated whether the plasma B-type natriuretic peptide (BNP) level on admission could predict the status of myocardial tissue perfusion in patients who underwent primary percutaneous coronary intervention (PCI). METHODS: The study prospectively enrolled 102 patients with STEMI who underwent primary PCI within 12 h of symptom onset. The grade of myocardial tissue perfusion was measured by ST-segment resolution, corrected thrombolysis in myocardial infarction frame count, and myocardial blush grade after primary PCI. All-cause mortality at 1 month after PCI was assessed. RESULTS: All patients were divided into two groups according to the BNP level; high-BNP group (≥80 pg/ml, n=43) and low-BNP group (<80 pg/ml, n=59). High-BNP group had significantly lower ST-segment resolution (42.69 ± 24.85 vs. 71.15 ± 19.37%, P<0.001), higher corrected thrombolysis in myocardial infarction frame count (53.7 ± 19.7 vs. 44.5 ± 15.5, P=0.04), lower myocardial blush grade (2.4 ± 0.9 vs. 2.9 ± 0.3, P=0.001), and higher short-term mortality (16.2 vs. 3.3%, P=0.023). In multivariate logistic regression analysis for prediction of good myocardial tissue perfusion after PCI, the odds ratio of low-BNP group was 4.12 (95% confidence interval 1.49-13.08, P<0.01). CONCLUSION: The patients with STEMI who had higher BNP level on admission showed inadequate myocardial tissue perfusion status after primary PCI. The plasma BNP level on admission may serve as a predictor of tissue perfusion after primary PCI in patients with STEMI.
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