NT-proBNP level before primary PCI and risk of poor myocardial reperfusion

• Verfasst von: Fabris, Enrico [VerfasserIn]
• Verfasst von: ten Berg, Jurrien M. [VerfasserIn]
• Verfasst von: Hermanides, Renicus S. [VerfasserIn]
• Verfasst von: Ottervanger, Jan Paul [VerfasserIn]
• Verfasst von: Dambrink, Jan Henk E [VerfasserIn]
• Verfasst von: Gosselink, AT Marcel [VerfasserIn]
• Verfasst von: Sinagra, Gianfranco [VerfasserIn]
• Verfasst von: Koopmans, Petra C. [VerfasserIn]
• Verfasst von: Giannitsis, Evangelos [VerfasserIn]
• Verfasst von: Hamm, Christian [VerfasserIn]
• Verfasst von: van ’t Hof, Arnoud W. J. [VerfasserIn]
• Titel: NT-proBNP level before primary PCI and risk of poor myocardial reperfusion
• Titelzusatz: insight from the On-TIME II trial
• Verf.angabe: Enrico Fabris, MD, PhD, Jurrien M. ten Berg, MD, PhD, Renicus S. Hermanides, MD, PhD, Jan Paul Ottervanger, MD, PhD, Jan Henk E Dambrink, MD, PhD, AT Marcel Gosselink, MD, PhD, Gianfranco Sinagra, MD, Petra C.Koopmans, PhD, Evangelos Giannitsis, MD, PhD, ChristianHamm, MD, PhD, and Arnoud W.J. van’t Hof, MD, PhD
• Jahr: 2021
• Umfang: 8 S.
• Teil: volume:233
• Teil: year:2021
• Teil: pages:78-85
• Teil: extent:8
• Fussnoten: Available online 31 December 2020 ; Gesehen am 07.09.2021
• Titel Quelle: Enthalten in: American heart journal
• Ort Quelle: Amsterdam [u.a.] : Elsevier, 1925
• Jahr Quelle: 2021
• Band/Heft Quelle: 233(2021), Seite 78-85
• ISSN Quelle: 1097-6744
• DOI: doi:10.1016/j.ahj.2020.12.017
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1753532248

Abstract

Background - N-terminal fragment of the brain natriuretic peptide prohormone (NT-proBNP), a marker for neurohumoral activation, has been associated with adverse outcome in patients with myocardial infarction. NT-proBNP levels may reflect extensive ischemia and microvascular damage, therefore we investigated the potential association between baseline NT-proBNP level and ST-resolution (STR), a marker of myocardial reperfusion, after primary percutaneous coronary intervention (pPCI). - Methods - we performed a post-hoc analysis of the On-TIME II trial (which randomized ST-elevation myocardial infarction (STEMI) patients to pre-hospital tirofiban administration vs placebo). Patients with measured NT-proBNP before angiography were included. Multivariate logistic-regression analyses was performed to investigate the association between baseline NTproBNP level and STR one hour after pPCI. - Results - Out of 984 STEMI patients, 918 (93.3%) had NT-proBNP values at baseline. Patients with STR <70% had higher NT-proBNP values compared to patients with complete STR (>70%) [Mean ±SD 375.2 ±1021.7 vs 1007.4 ±2842.3, Median (IQR) 111.7 (58.4-280.0) vs 168.0 (62.3-601.3), P <.001]. At multivariate logistic regression analysis, independent predictors associated with higher risk of poor myocardial reperfusion (STR <70%) were: NT-proBNP (OR 1.17, 95%CI 1.04-1.31, P=.009), diabetes mellitus (OR 1.87, 95%CI 1.14-3.07, P=.013), anterior infarct location (OR 2.74, 95% CI 2.00-3.77, P <.001), time to intervention (OR 1.06, 95%CI 1.01-1.11, P=.021), randomisation to placebo (OR 1.45, 95%CI 1.05-1.99, P=.022). - Conclusions - In STEMI patients, higher baseline NT-proBNP level was independently associate with higher risk of poor myocardial reperfusion, supporting the potential use of NT-proBNP as an early marker for risk stratification of myocardial reperfusion after pPCI in STEMI patients.