N-Terminal Pro-Brain Natriuretic Peptide on Admission in Patients With Acute Myocardial Infarction and Correlation With Scintigraphic Infarct Size, Efficacy of Reperfusion, and Prognosis

We investigated whether N-terminal pro-brain natriuretic peptide (NT–pro-BNP) that was measured on admission in patients with acute myocardial infarction (AMI) predicts the efficacy of reperfusion or whether NT–pro-BNP provides prognostic information independent of infarct size as estimated by single-photon emission computed tomographic scintigraphy. The study included 174 patients with ST-segment elevation AMI who were admitted within 24 hours of pain onset. NT–pro-BNP level was measured on admission. Paired scintigraphic studies (before and 7 to 14 days after reperfusion) were performed to assess infarct size and define myocardial salvage. One-year clinical follow-up was assessed. Patients were categorized into the high NT–pro-BNP group (57 patients in the upper tertile of NT–pro-BNP) and low NT–pro-BNP group (117 patients in the middle and lower tertiles of NT–pro-BNP). Initial median perfusion defect was 35.0% (interquartile rage 20.0 to 53.0%) of the left ventricle in the high NT–pro-BNP group versus 19.0% (interquartile range 10.0 to 32.2) of the left ventricle in the low NT–pro-BNP group (p