العلاقة بين مستوى الببتيد الدماغي المدر للصوديوم و تراجع القطعة ST بعد إعادة التروية لدى مرضى احتشاء العضلة القلبية الحاد

الملخص EN

Objective: To investigate the association between plasma NT-proBNP levels at admission and ST-segment resolution (STR) after reperfusion in patients with ST-segment elevation myocardial infarction (STEMI).

Methods: This study included 102 patients with ST-segment elevation myocardial infarction (STEMI), who were admitted to coronary care unit at Aleppo University Heart Hospital between 1 Mars 2011 until 1 October 2011 were treated by lysis in less than 6 hours from symptoms onset, and randomly selected blood sample was taken on admission to measure plasma NT-proBNP.

Maximal ST-segment elevation was measured on the worst ECG lead before and 60-90 minutes after reperfusion.

Patients were categorized as STR(−) (<50% STR) or STR(+) (≥50% STR).

Results: Of the 102 patients included, 75 (73.5%) were STR(+).

The STR(−) group had higher median levels of NT-proBNP: 413 (59-3000) vs 79 (27-2450) pg/ml, p<0.001.

On multivariate analysis, none of the following factors including age, gender, diabetes mellitus, hypertension, smoking and infarct location had a significant association with ST-segment resolution.

only NT-proBNP level and the period between symptoms onset and therapy initiation were independent predictor factors for STR.

STR(−) patients had a higher in-hospital major cardiac events (mortality, cardiogenic shock, malignant arrhythmias) than STR(+) group, (37% vs 13%, respectively), p=0.01.

Patients with Timi flow grade (0 or 1) in coronary angiography had higher median levels of NT-proBNP: (320 vs 130 and 97) pg/ml for Timi flow grade 2 and 3, respectively.

Conclusions: We found a strong association between high levels of NT-proBNP at admission and incomplete STR in our study, suggesting that NT-proBNP may be useful to predict the prognosis in acute myocardial infarction patients at the first evaluation