Original article Left ventricular dysfunction and NT-proBNP levels in patients with one-vessel disease after first ST-elevation myocardial infarction treated with primary coronary angioplasty

Abstract

Background: Cardiovascular diseases continue to be the main cause of death in the general population. Despite the fact that primary percutaneous coronary intervention (PCI) improves prognosis in patients with acute myocardial infarction (AMI), heart failure can still develop in some of these subjects. Measurement of natriuretic peptide levels has been shown to be useful in the detection of left ventricular (LV) dysfunction and the risk stratification of patients with AMI.
Aim: To evaluate the role of NT-proBNP in the identification of patients with early systolic LV dysfunction after first AMI with one--vessel disease successfully treated with primary PCI.
Methods: 161 consecutive patients with first ST-elevation AMI treated with primary PCI with stent implantation (occlusion in infarct-related artery was the patient’s only lesion) were included. Measurement of NT-proBNP level and echocardiography were performed on the 4-5th day of AMI.
Results: In 53 (33%) patients LV dysfunction (defined as EF < 55%) was detected. The remaining 108 (67%) patients had normal LV systolic function. Multivariate regression analysis revealed that NT-proBNP level > 463.4 pg/ml (median level) was the strongest predictor of EF < 55%. A strong negative correlation between EF and NT-proBNP concentration measured on the 4-5th day of AMI was observed (r = –0.54), which increased with decreasing EF value.
Conclusions: Elevated levels of NT-proBNP are the strongest predictor of early LV dysfunction in low-risk patients after first AMI with one-vessel disease treated with primary PCI with complete coronary revascularisation.