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B-type natriuretic peptide and assessment of jeopardised myocardium in acute myocardial infarction

Anne Vorlat1, Marc J Claeys, Johan M Bosmans

  • 1Department of Cardiology, Antwerp University Hospital, Belgium. anne.vorlat@uza.be

International Journal of Cardiology
|April 29, 2006
PubMed

Insights

B-type natriuretic peptide (BNP) levels do not predict myocardial damage in ST-elevation myocardial infarction (STEMI). Electrocardiogram (ECG) ST-segment analysis, however, effectively estimates jeopardized myocardium in acute STEMI patients.

Area of Science:

  • Cardiology
  • Biomarkers
  • Acute Coronary Syndromes

Background:

  • B-type natriuretic peptide (BNP) is a recognized prognostic marker in acute coronary syndromes.
  • The utility of BNP in quantifying jeopardized myocardium during the acute phase of ST-elevation myocardial infarction (STEMI) remains unclear.

Purpose of the Study:

  • To investigate whether BNP levels at the time of percutaneous coronary intervention correlate with the extent of jeopardized myocardium in STEMI patients.
  • To compare the predictive value of BNP with electrocardiogram (ECG) findings for assessing myocardial damage.

Main Methods:

  • Studied 113 patients undergoing percutaneous coronary intervention for acute STEMI.
  • Correlated plasma BNP levels, measured during intervention, with myocardial jeopardy assessed by coronary angiography (vascular score).
  • Evaluated ECG parameters, including ST-segment elevation and depression, to assess epicardial injury extent.

Main Results:

  • No significant correlation was found between BNP levels and the vascular score (r=0.026, p=0.8).
  • The primary determinant of BNP levels was the time delay from symptom onset to sample collection.
  • The extent of ST-segment elevation on ECG independently predicted the vascular score.

Conclusions:

  • BNP measurements at initial STEMI presentation are not reliable predictors of the amount of jeopardized myocardium.
  • ST-segment analysis on ECG, particularly the degree of ST-segment elevation, offers valuable insights into the extent of myocardial injury.
Abstract

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