RESUMO
Increased levels of N-terminal pro-brain natrituretic peptide [NT-pro BNP] are now recognized as a new and useful biochemical marker that is predictive of clinical outcomes in patients with congestive heart failure [CHF] and short-term death in patients with acute coronary syndromes, However, an association between an increased circulating level of this biomarker and clinical outcomes in patients following acute myocardial infarction AMI has not been fully delineated. Thus, the purpose of this study was to test whether NT-pro BNP obtained on admission can predict short-term outcome as well as the angiographic success of procedures in patients with ST-segment elevation myocardial infarction [STEMI] treated with primary percutaneous coronary intervention [PCI]. A prospective study of 60 consecutive patients with [STEMI] of onset within 24 hs who underwent [PCI] was conducted. Blood samples for plasma concentration of NT-pro BNP were collected following vascular puncture. Univariate analysis demonstrated that the 30-day composite major adverse clinical outcomes [MACO] [advanced killip score > 3, functional class >/= 3 of CHF. and 30 day mortality] were strongly associated with elevated NT-pro BNP [>243 pg/ml] [P=<0.001], unsuccessful reperfusion [final thrombolysis in myocardial infarction 243 [P=<0.001], LVEF <45% [P=<0.001], DM [P=<0.01] unsuccessful reperfusion [P=<0.002], and age [>/= 60 years] [P=<0.05] are independent predictors of 30 day MACO, Additionally, elevation of NT-pro BNP, together with advanced killip score and unsuccessful reperfusion, are significant independent predictors of increased 30- day mortality [all P values =<0.005], furthermore serum NT pro -BNP >100 pico g/ml was found to be a sensitive predictor of no-reflow phenomenon [P=<0.04]. Increased NT-pro BNP level on admission was the most independent predictor of 30 day MACO and angiographic success in patients with STEMI undergoing primary PCI