The relationship of BNP,hs-CRP with cardiac function in patients with acute myocardial infarction
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Objective To investigate the plassma levels of brain natriuretic peptide(BNP) and high-sensitivity C-reactive protein(hs-CRP) in patients with acute myocardial infarction(AMI),and estimate its value in the risk stratification.Methods The BNP and the serum levels of hs-CRP were detected in 128 cases with non-AMI and 120 cases with AMI.Left ventricular ejection fraction(LVEF) and left ventilator posterior wall thickness growing rate at systole(△T%) were measured by echocardiography.Results Compared with control group,AMI patients had high serum levels of hs-CRP.The higher the killip class was,the higher the levels of hs-CRP and BNP were.The concentration BNP and hs-CRP in AMI patients had a parallel rationship with LVEDD(P 0.05),but a nenative correlation with left ventricular ejection fraction(LVEF)(P 0.05).Conclusion The concentration of BNP and hs-CRP can help to evaluate the risk stratification and prognosis in patients with AMI.Keywords:
Brain natriuretic peptide
Risk Stratification
Killip class
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Objective To explore the relationship of serum natriuretic peptide(BNP) with myocardial infarct size and prognosis in acute myocardial infarction.Methods 128 patients with acute myocardial infarction were selected as research subjects.BNP and hs-CRP were detected,and LVEF was measured by heart color ultrasound.The relationship of serum BNP with myocardial infarct size and prognosis was studied.Results In inferior-posterior,anteroseptal wall and extensive anterior wall patients,the serum BNP and hs-CRP levels gradually increased and LVEF gradually decreased with significant differences (F =6.892,7.019,6.125,all P ＜ 0.05).13 cases died (10.2 ％).Comparison with survival cases,the BNP and hs-CRP levels greatly increased,and LVEF decreased in death cases (t =5.745,7.538,2.802,all P ＜ 0.01).Conclusion BNP greatly increased in acute myocardial infarction,and the BNP level was closely related with myocardial infarct size and prognosis.
Key words:
Myocardial infarction; Natriuretic peptide; Prognosis
Brain natriuretic peptide
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Objective To study the value of brain natriuretic peptide( BNP) and C-reactive pro- tein( CRP) in acute myocardial infarction. Methods The levels of BNP and CRP were measured in 126 patients with AMI and 40 healthy controls. The difference was compared between two groups. The mortality and the risks of major adverse cardiac events( including the composite end point of death,recurrent myocardial infarction,angina pectoris,heart failure,and re-hospitalization) at 28 d were analyzed. The correlation of BNP and CRP levels with MACE was compared. Results The levels of BNP and CRP in AMI group were significantly higher than control group( P 0. 01) . The levels of BNP and CRP in AMI patients of MACE group were significantly higher than those in non-MACE group ( P 0.01) . Conclusion The levels of BNP and CRP had a certain clinical significance on diagno- sis,prognosis and assessment of AMI patients.
Mace
Brain natriuretic peptide
Unstable angina
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Objective To evaluate the value of brain natriuretic peptide(BNP) in estimating risk stratification in patients with acute myocardial infarction(AMI) and to determine the relationship between BNP and adverse cardiac events after AMI.Methods The 135 subjects were selected into the study including 25 healthy subjects and 110 patients with a first AMI.The plasma concentrations of BNP were measured at two to four days after infarction in patients and healthy controls.Left ventricular function was evaluated by echocardiography with the parameters of left ventricular ejection function(LVEF) after 3 months.Patients were followed up at 12 months.The main outcome measures were heart failure,left remodeling mortality and other adverse cardiac events at one year.Results Plasma BNP concentrations in patients with AMI were much higher than those in the health control people[(416.7±208.0)ng/L versus (61.8±34.1)ng/L,P0.01].The BNP count ranged from 5 to 2500ng/L in AMI patients.There was no association between the BNP count and mortality rate.The development of new congestive heart failure(CHF) was associated with a higher BNP count(P=0.02).The development of any of the clinical end point(death/CHF/shock) occurred move frequently in patients with a higher BNP count(13.8% for BNP count of 100ng/L,39.1% for BNP count of 100～200ng/L,43% for BNP count of 200～400ng/L 46.4% for BNP count of 400ng/L,P=0.019).Plasma BNP concentrations remained associated with the development of clinical end points in multivariable model that adjusted for potential confounding variables.Conclusion The results of the present study confirm that the elevated BNP count related to the risk stratification and prognosis in patients with AMI elevations in BNP count is associated with a higher incidence of new CHF and adverse clinical outcomes after AMI it could serve as s strong predictor for the subsequent development of poor outcomes in AMI patients.
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Objective:To examine the correlation of the C-reactive protein(CRP) levels and Cardiac function.Methods:The serum levels of CRP were detected in 40 healthy adults and 109 patients with AMI.The datas of remodeling and cardiac function left ventricular ejection fraction(LVEF) and left ventriadar posterior wall thickness growing rate at systole(△T%) were measured by echocardiography in all persons.Results:Compared with control group,AMI patients had high serum levels of CRP(P0.01).The higher the upgrading of Killip class,the higher the levels of CRP(P0.01).The levels of CRP were negative correlation with Killip class(r=0.38,P0.01).Conclusion:The levels of serum CRP significantly increased in the AMI patients.The levels of CRP are negative correlation with Killip class.
Killip class
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Background— Circulating levels of B-type natriuretic peptide (BNP), a cardiac hormone, reflect the severity of cardiac dysfunction. Because the plasma BNP level changes dramatically during the period after the onset of acute myocardial infarction (AMI), identification of a suitable sampling time is problematic. There have been several reports indicating that the plasma BNP level obtained in the acute phase of AMI can be used as a prognostic marker. We examined whether the plasma BNP level measured 3 to 4 weeks after the onset of AMI represents a reliable prognostic marker for patients with AMI. Methods and Results— We analyzed 145 consecutive patients with AMI. Plasma BNP levels were measured during the 3 to 4 weeks after onset of AMI. Of those patients, 23 experienced fatal cardiac events during this study. The mean follow-up period was 58.6 months. Log BNP, left ventricular end-diastolic pressure, and pulmonary vascular resistance were all significantly higher in the cardiac death group, and there were more men and more patients with a history of heart failure in the cardiac death group. A Cox proportional hazards model analysis showed that log BNP was an independent predictor of cardiac death. The survival rate was significantly higher in patients with log BNP <2.26 (180 pg/mL) than in those with log BNP ≥2.26. Conclusions— The plasma BNP level obtained 3 to 4 weeks after the onset of AMI can be used as an independent predictor of cardiac death in patients with AMI.
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Objective To investigate the correlation of B-type natriuretic peptide(BNP) levels with acute heart failure and hospital mortality in patients with acute myocardial infarction(AMI). Methods 294 patients with newly diagnosed AMI were divided into 2 groups,22 in death group and 272 in survival group.Killip classification of cardiac function,determination of plasma BNP concentration 14 to 18 hours after disease onset,echocardiographic determination of LVEF and E/A ratio 24 to 48 hours after disease onset,and occurrence of death during hospitalization were recorded.262 patients' LVEF was≥40%,while 32 patients' LVEF was40%;152 patients were in Killip classificationⅠ,99 in Killip classificationⅡ,and 43 in Killip classificationⅢ-Ⅳ. Results Blood BNP increased significantly in accordance with the Killip classificationⅠ,Ⅱ,Ⅲ—Ⅳ(P0.01).In acute stage of AMI,Killip classification of cardiac function and cardiac enzymes peak were positively correlated with BNP,E/A ratio was negatively correlated with BNP.BNP level was significantly higher in death group than in survival group[(2399.0±1626.0) ng/L vs (480.8±676.0) ng/L,P0.01].BNP was a predictive factor of hospital mortality of AMI patients (QR = 1.259,P = 0.028).Conclusion Plasma BNP in high-risk patients with AMI is significantly increased and significantly correlated with Killip classification,diastolic function and death.BNP may be a predictive factor for hospital mortality of AMI patients.
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Objective To examine the correlation of the high sensitive-CRP(hs-CRP) levels and BNP with Cardiac function during the onset of acute myocardial infarction(AMI).Methods The serum levels of hs-CRP,BNP were detected in 81 with non-AMI and 86 patients with AMI.Left ventricular ejection fraction(LVEF)and left ventilator posterior wall thickness growing rate at systole(△T%) were measured by echocardiography.Results Compared with control group,AMI patients had high serum levels of hs-CRP.The higher of Killip class,the higher the levels of hs-CRP and BNP.The levels of hs-CRP and BNP were positive correlation with Killip class(r=0.38,r=0.51,P0.01).Conclusion The levels of serum hs-CRP and BNP significantly increased in the AMI patients.The levels of hs-CRP and BNP are positive correlation with Killip class.
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Brain natriuretic peptide (BNP) is released from ventricular myocites due to their stretching and volume overload.In heart failure there is BNP release.Aim of this study was to observe BNP release in acute myocardial infarction (AMI).We measured BNP in patients with AMI.Control group (n=) was similar by age and gender to AMI group.We found statistically signifi cant elevation of BNP compared to controls (.pg/ml vs . pg/ml, p< .).Patients with severe systolic dysfunction had the highest BNP levels, while patients with the preserved systolic function had the lowest BNP levels (Group with EF< BNP= .pg/ml vs Group with EF- BNP= . pg/ml vs Group with EF - BNP= . pg/ml vs Group with EF> BNP= . pg/ml, p< .).We found statistically signifi cant light positive correlation between BNP and left ventricle end-diastolic diameter (LVDd) (r= ., p<.).and real positive correlation between BNP and peak troponin levels (r= ., p < .).BNP levels were higher in anteroseptal allocation of AMI compared to inferior allocation (.pg/ml vs . pg/ml, p< .) and in patients who were treated with heparin compared to fi brinolitic therapy (.pg/ml vs . pg/ml, p< .).BNP is elevated in AMI and is a quantitative biochemical marker related to the extent of infarction and the left ventricle systolic dysfunction.Besides echocardiographic calculation, elevation of BNP could be used for quick and easy determination of the left ventricle systolic dysfunction.
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Objective:To investigate the Correlations between serum high sensitivity C reactive protein(CRP) level and cardiac functions in acute myocardial infarction.Methods:The serum levels of CRP and BNP were examined in 50 healthy adults and 121 patients with AMI.Left ventricular ejection fraction(LVEF) was measured by echocardiography and the levels of CRP and BNP were detected by ELISA.Results:Compared with control group,AMI patients had high serum levels of CRP and BNP(P0.01).The serum levels of CRP and BNP of Killip III and IV class is higher than those of Killip I and II class CRP(P0.01).Conclusion:Just as BNP,The serum CRP level can be a sensitive index in the patients with acute myocardial infarction.
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Abstract This study was designed to measure the correlation between left ventricular (LV) remodeling 3 months after successful reperfusion therapy, and the levels of serum N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) and high‐sensitivity C‐reactive protein (hs‐CRP) at 3 days after acute myocardial infarction (AMI), and to determine the predictive levels of NT‐proBNP and hs‐CRP for LV remodeling. A total of 106 patients with first AMI were included in this study. Each patient was examined by echocardiography (ECG) on the third day and third month after AMI, and LV remodeling was determined by the difference in the LEV end‐diastolic volume (LVEDV) between the third day and the third month. Serum NT‐proBNP and hs‐CRP level were measured 3 days after AMI. Then the correlation between the 3‐months change in LVEDV and the levels of serum NT‐proBNP or hs‐CRP was determined. In addition, sensitivity and specificity were calculated with a receiver operating characteristic (ROC) curve to identify correspondence with LV remodeling (defined as the change rate of LVEDV >20%). Our results showed that the correlation coefficients with the change of LVEDV were 0.706 for serum NT‐pro BNP ( P <0.001) and 0.596 for hs‐CRP ( P <0.05). With a cutoff value of 0.2, the area under the ROC curve (AUC) was 0.894 for NT‐proBNP and 0.825 for hs‐CRP. Although the AUC did not statistically differ between NT‐proBNP and hs‐CRP, NT‐proBNP is more effective than serum hs‐CRP as a marker to predict LV remodeling. J. Clin. Lab. Anal. 20:19–22, 2006. © 2006 Wiley‐Liss, Inc.
Brain natriuretic peptide
Ventricular remodeling
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