open access

Vol 19, No 5 (2012)
Original articles
Published online: 2012-10-06
Get Citation

N-terminal pro-brain natriuretic peptide and electrocardiographic variables associated with increased risk of complete atrioventricular block and mortality in patients with acute inferior myocardial infarction

Bilal Geyik, Ozcan Ozdemir, Damirbek Osmonov, Mustafa Ozcan Soylu
DOI: 10.5603/CJ.2012.0088
·
Cardiol J 2012;19(5):479-486.

open access

Vol 19, No 5 (2012)
Original articles
Published online: 2012-10-06

Abstract


Background: Although brain natriuretic peptide (BNP) levels are shown to be an important prognostic factor in patients with acute myocardial infarction (MI), the relationship between arrhythmias and BNP levels is not known. This study assessed whether baseline clinical factors, N-terminal-proBNP (NT-proBNP) levels and electrocardiographic patterns of acute inferior MI are associated with greater risk of developing complete atrioventricular block (CAVB) and mortality.
Methods and Results: Seventy-nine consecutive patients (52 male, 27 female with an avarage age of 64.2 ± 10.9 years) with CAVB and 119 control patients (93 male, 16 female with an average age of 57.7 ± 11.4 years) without CAVB were enrolled. Regression analysis revealed that NT-proBNP levels > 104 pg/mL increased the development of CAVB by 16.7 folds, > 1 mm ST elevation in RV4 by 2.7 folds, ratio of elevation in lead III:II > 1.5 by 10.1 folds but the thrombolytic therapy decreased the development of CAVB by 2.8 folds. NT-proBNP > 92 pg/mL increased the mortality by 8.9 folds, a ratio of ST-segment elevation in lead III:II > 1 by 3.1 folds, ST segment elevation > 1 mm in RV4 by 3.5 folds, ejection fraction < 35% by 24.2 folds, age > 65 years by 8.3 folds and CAVB by 6.8 folds, on contrary thrombolytic treatment decreased the mortality by 3.3 folds.
Conclusions: Simple electrocardiographic measurements and NT-proBNP levels at admission can be used as a screening test for development of complications such as CAVB, right ventricular involvement and mortality during acute inferior wall MI. (Cardiol J 2012; 19, 5: 479-486)

Abstract


Background: Although brain natriuretic peptide (BNP) levels are shown to be an important prognostic factor in patients with acute myocardial infarction (MI), the relationship between arrhythmias and BNP levels is not known. This study assessed whether baseline clinical factors, N-terminal-proBNP (NT-proBNP) levels and electrocardiographic patterns of acute inferior MI are associated with greater risk of developing complete atrioventricular block (CAVB) and mortality.
Methods and Results: Seventy-nine consecutive patients (52 male, 27 female with an avarage age of 64.2 ± 10.9 years) with CAVB and 119 control patients (93 male, 16 female with an average age of 57.7 ± 11.4 years) without CAVB were enrolled. Regression analysis revealed that NT-proBNP levels > 104 pg/mL increased the development of CAVB by 16.7 folds, > 1 mm ST elevation in RV4 by 2.7 folds, ratio of elevation in lead III:II > 1.5 by 10.1 folds but the thrombolytic therapy decreased the development of CAVB by 2.8 folds. NT-proBNP > 92 pg/mL increased the mortality by 8.9 folds, a ratio of ST-segment elevation in lead III:II > 1 by 3.1 folds, ST segment elevation > 1 mm in RV4 by 3.5 folds, ejection fraction < 35% by 24.2 folds, age > 65 years by 8.3 folds and CAVB by 6.8 folds, on contrary thrombolytic treatment decreased the mortality by 3.3 folds.
Conclusions: Simple electrocardiographic measurements and NT-proBNP levels at admission can be used as a screening test for development of complications such as CAVB, right ventricular involvement and mortality during acute inferior wall MI. (Cardiol J 2012; 19, 5: 479-486)
Get Citation

Keywords

complete atrioventricular block; ST-segment elevation inferior myocardial infarction; brain natriuretic peptide

About this article
Title

N-terminal pro-brain natriuretic peptide and electrocardiographic variables associated with increased risk of complete atrioventricular block and mortality in patients with acute inferior myocardial infarction

Journal

Cardiology Journal

Issue

Vol 19, No 5 (2012)

Pages

479-486

Published online

2012-10-06

DOI

10.5603/CJ.2012.0088

Bibliographic record

Cardiol J 2012;19(5):479-486.

Keywords

complete atrioventricular block
ST-segment elevation inferior myocardial infarction
brain natriuretic peptide

Authors

Bilal Geyik
Ozcan Ozdemir
Damirbek Osmonov
Mustafa Ozcan Soylu

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl