Utilizing natriuretic peptides for predicting heart failure risk following myocardial infarction

In Mongolia, ischemic heart disease, specifically acute myocardial infarction (AMI), is a significant etiology of chronic heart failure (HF). Therefore, early recognition of the risk of HF following AMI is critically important for improving patient management. This study aimed to assess the N-terminal pro-B-type natriuretic peptide (NT-proBNP) as an early detection and prognosis of asymptomatic left ventricular (LV) dysfunction following AMI.

Patients diagnosed with AMI and in the absence of symptoms or signs of HF were prospectively included. Clinical and echocardiographic data were collected at baseline, and NT-proBNP levels were measured at admission and discharge. Patients were divided into four distinct groups based on NT-proBNP level quartiles. The study endpoint was de-novo HF at 6 months after AMI.

A total of 120 patients with a mean age of 56.0 ± 9.2 years and 80.8% (N = 97) men were included. Higher NT-proBNP levels were associated with elevated GRACE score and diabetes, both at admission and predischarge. Additionally, higher NT-proBNP levels at admission were associated with delayed hospital presentation, whereas higher NT-proBNP levels at predischarge were associated with reduced LV global longitudinal strain. Furthermore, NT-proBNP level at predischarge was significantly associated with the development of HF 6 months after AMI, with a threshold value of 1410 pg/ml.

Incorporation of NT-proBNP measurement before discharge in AMI patients could enhance risk stratification, thereby supporting its integration into routine clinical evaluation for more efficient patient management.