Study on the relationship between plasma brain natriuretic peptide level and the location and prognosis of acute myocardial infarction in elderly people / 中华老年医学杂志

ABSTRACT

Objective To explore the relationship between plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) level and the location and prognosis of acute ST-segment elevation myocardial infarction (STEMI) in elderly people.Methods From May 2012 to April 2014, the 137 elderly patients (aged≥60 years) with acute STEMI within 24 h after symptoms onset admitted in cardiovascular department of Ningbo First Hospital were selected as acute myocardial infarction group (AMI group), and 40 elderly healthy people (age≥60 years) as control group.The plasma NT-proBNP levels were detected by enzyme linked immunosorbent assay(ELISA), and compared between the two groups.The patients in AMI group were classified into four subgroups anterior AMI group (A group, n=44), anterolateral AMI group (B group, n=21), anterior septal AMI group (C group,n=18) and inferior AMI group (D group, n=54), and the changes of plasma NT-proBNP levels in different infarction location were explored.Meanwhile, all patients were followed up for 30 days and 1 year to observe major adverse cardiac events (MACEs) and mortality rate, then to explore the relationship between plasma NT-proBNP level and prognosis in elderly people with STEMI.Results The plasma NT-proBNP levels were significantly higher in AMI group than in control group [(1 406.2±1 322.5)ng/L vs.(63.7±18.5) ng/L, P＜0.01].The changes of plasma NT-proBNP levels in high-to-low sequence were from A group to B group to C group to D group and to control group (P＜0.05).At 30 days, the plasma NT-proBNP levels were higher in death group than in survival group (P＜0.05), and were higher in MACE group than in non-MACE group (P＜0.05).At one year, there were no significant differences in plasma NT-proBNP levels between death group and survival group (P＞0.05), and the plasma NT-proBNP levels were higher in MACE group than in non-MACE group (P＜0.05).Conclusions In elderly STEMI patients, there is a correlation between plasma NT-proBNP levels and infarct location, with the highest NT-proBNP level in anterior AMI.The plasma NT-proBNP level could predict MACE.