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Prognostic value of N-terminal probrain natriuretic peptide level on admission in patients with acute myocardial infarction and preserved left ventricular ejection fraction.

 Sung-Ai Kim  ;  Sang-Jae Rhee  ;  Chi-Young Shim  ;  Jung-Sun Kim  ;  Sungha Park  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Namsik Chung  ;  Jong-Won Ha 
 CORONARY ARTERY DISEASE, Vol.22(3) : 153-157, 2011 
Journal Title
Issue Date
Aged ; Biomarkers/blood* ; Cohort Studies ; Diagnostic Tests, Routine ; Female ; Humans ; Male ; Middle Aged ; Myocardial Infarction/blood* ; Myocardial Infarction/physiopathology* ; Natriuretic Peptide, Brain/blood* ; Prognosis ; Prospective Studies ; Stroke Volume* ; Ventricular Function, Left*
BACKGROUND: Little is known about the prognosis of patients with acute myocardial infarction (MI) and preserved left ventricular ejection fraction (LVEF), a condition that is becoming increasingly common. This study sought to identify independent predictors of adverse outcomes in patients with acute MI and preserved LVEF. METHODS: We studied the prognosis of 555 patients with acute MI (mean age 62 years, 287 men) and preserved LVEF (>40%). Primary endpoint was a composite of cardiovascular (CV) death and rehospitalization for heart failure (HF). RESULTS: During follow-up of a median 24 months (range 0-50 months), there were 34 cardiac events (cardiac death in 28 and rehospitalization for HF in six patients). Significant univariate predictors of CV death and rehospitalization for HF were age, Killip class greater than I, revascularization, estimated glomerular filtration rate, log N-terminal probrain natriuretic peptide (NT-proBNP), LVEF, left atrial volume index, and the ratio of early diastolic mitral inflow velocity to early diastolic mitral annular velocity (E/E') greater than 15. In multivariate Cox analysis, age (hazard ratio 1.05, 95% confidence interval: 1.01-1.09, P=0.02) and log NT-proBNP (hazard ratio 2.08, 95% confidence interval: 1.61-2.70, P<0.001) independently predicted CV death and rehospitalization for HF. Receiver operating curve analysis indicated that NT-proBNP showed significantly higher areas under the receiver operating characteristic curve value than other significant predictors including left atrial volume index and estimated glomerular filtration rate for prediction of adverse outcomes. CONCLUSION: NT-proBNP showed a strong predictive power for adverse outcomes beyond traditional risk factors and echocardiographic indices of LV systolic and diastolic function in patients with acute MI and preserved LVEF.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Sung Ai(김성애)
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Shim, Chi Young(심지영) ORCID logo https://orcid.org/0000-0002-6136-0136
Lee, Sang Jae(이상재)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Chung, Nam Sik(정남식)
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Ha, Jong Won(하종원) ORCID logo https://orcid.org/0000-0002-8260-2958
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