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Abdel-Dayem K, Eweda II, El-Sherbiny A, et al. Cutoff Value of Admission N-Terminal Pro-Brain Natriuretic Peptide Which Predicts Poor Myocardial Perfusion after Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction. Acta Cardiol Sin. 2016;32(6):649-655doi: 10.6515/acs20151112b.
Abdel-Dayem, K., Eweda, I. I., El-Sherbiny, A., Dimitry, M. O., & Nammas, W. (2016). Cutoff Value of Admission N-Terminal Pro-Brain Natriuretic Peptide Which Predicts Poor Myocardial Perfusion after Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction. Acta Cardiologica Sinica, 32(6), 649-655. https://doi.org/10.6515/acs20151112b
Abdel-Dayem, Khairy, et al. "Cutoff Value of Admission N-Terminal Pro-Brain Natriuretic Peptide Which Predicts Poor Myocardial Perfusion after Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction." Acta Cardiologica Sinica vol. 32,6 (2016): 649-655. doi: https://doi.org/10.6515/acs20151112b
Abdel-Dayem K, Eweda II, El-Sherbiny A, Dimitry MO, Nammas W. Cutoff Value of Admission N-Terminal Pro-Brain Natriuretic Peptide Which Predicts Poor Myocardial Perfusion after Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction. Acta Cardiol Sin. 2016 Nov;32(6):649-655. doi: 10.6515/acs20151112b. PMID: 27899851; PMCID: PMC5126442.
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Acta Cardiol Sin. 2016 Nov;32(6):649-655. doi: 10.6515/acs20151112b.

Cutoff Value of Admission N-Terminal Pro-Brain Natriuretic Peptide Which Predicts Poor Myocardial Perfusion after Primary Percutaneous Coronary Intervention for ST-Segment-Elevation Myocardial Infarction.

Acta Cardiologica Sinica

Khairy Abdel-Dayem, Inas I Eweda, Ashraf El-Sherbiny, Marc O Dimitry, Wail Nammas

Affiliations

  1. Cardiology Department, Faculty of Medicine, Ain Shams University.
  2. Internal Medicine Department, National Research Center, Cairo, Egypt.

PMID: 27899851 PMCID: PMC5126442 DOI: 10.6515/acs20151112b

Abstract

BACKGROUND: We explored the value of admission levels of N-terminal pro-brain natriuretic peptide (NTProBNP) that best predicts poor myocardial tissue perfusion following primary percutaneous coronary intervention (PPCI) in patients admitted with acute ST-segment-elevation myocardial infarction (STEMI).

METHODS: We enrolled 90 consecutive patients admitted with acute STEMI who underwent PPCI and achieved post-procedural TIMI flow grade 3 in the infarct-related artery. We measured levels of NTProBNP from admission blood samples. Thereafter, we assessed post-procedural myocardial blush grade (MBG) at the end of PPCI, and further measured ST segment resolution (STR) 90 minutes following PPCI. The primary endpoint was STR < 50%; furthermore, the co-primary angiographic endpoint was postprocedural MBG 0/1.

RESULTS: The mean age of study subjects was 53.6 ± 10.9 years (74.4% males). We found that NTProBNP was higher in patients with STR < 50% versus those with STR ≥ 50% (p < 0.001), and in patients with post-procedural MBG 0/1 versus those with MBG 2/3 (p < 0.001). A value of NTProBNP ≥ 420 ng/L was the optimal cutoff value that best predicted < 50% STR; it predicted < 50% STR with sensitivity, specificity, positive and negative predictive value of 98.4%, 92.3%, 96.9%, and 96%, respectively. Likewise, a value of NTProBNP ≥ 570 ng/L was the optimal cutoff value that best predicted postprocedural MBG 0/1; it predicted MBG 0/1 with sensitivity, specificity, positive and negative predictive value of 92.2%, 66.7%, 78.3%, and 86.7%, respectively.

CONCLUSIONS: In patients with STEMI who underwent PPCI and ended up with successful recanalization of the epicardial infarct-related artery, elevated admission levels of NTProBNP predicted incomplete post-procedural STR with good sensitivity and specificity, and predicted poor post-procedural myocardial blush with good sensitivity and moderate specificity.

Keywords: Myocardial blush grade; N-terminal pro-brain natriuretic peptide; Primary percutaneous coronary intervention; ST-segment resolution; ST-segment-elevation myocardial infarction

References

  1. J Am Coll Cardiol. 1998 Oct;32(4):890-7 - PubMed
  2. Coron Artery Dis. 2011;22(6):405-10 - PubMed
  3. Circulation. 1994 Jul;90(1):195-203 - PubMed
  4. Adv Biomed Res. 2014 Sep 04;3:186 - PubMed
  5. Circulation. 2002 Dec 3;106(23):2913-8 - PubMed
  6. Circulation. 2012 Oct 16;126(16):2020-35 - PubMed
  7. Eur J Heart Fail. 2004 Mar 15;6(3):257-60 - PubMed
  8. J Am Coll Cardiol. 2002 Feb 20;39(4):591-7 - PubMed
  9. Korean Circ J. 2011 Jul;41(7):372-8 - PubMed
  10. J Am Coll Cardiol. 1998 Feb;31(2):338-43 - PubMed
  11. Circulation. 1998 Jun 16;97(23):2302-6 - PubMed
  12. Am J Emerg Med. 2001 Jan;19(1):25-8 - PubMed
  13. Am J Cardiol. 2000 Feb 1;85(3):299-304 - PubMed
  14. Am J Cardiol. 2010 Jun 15;105(12 ):1692-7 - PubMed
  15. Circulation. 1996 Jun 1;93(11):1963-9 - PubMed
  16. Circulation. 1992 May;85(5):1699-705 - PubMed
  17. J Am Coll Cardiol. 1995 Dec;26(7):1657-64 - PubMed
  18. Am Heart J. 2007 Apr;153(4):612-20 - PubMed
  19. Circulation. 2000 Jan 18;101(2):125-30 - PubMed
  20. Clin Chim Acta. 2004 Mar;341(1-2):41-8 - PubMed
  21. Circulation. 2003 Apr 29;107(16):2115-9 - PubMed
  22. Circulation. 1996 Sep 15;94(6):1269-75 - PubMed
  23. Circulation. 1996 Jan 15;93(2):223-8 - PubMed
  24. J Am Coll Cardiol. 2001 Jan;37(1):9-18 - PubMed
  25. Circulation. 1999 Apr 20;99(15):1972-7 - PubMed

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