Acuña-Valerio J, González-Pacheco H

Idioma: Español
Referencias bibliográficas: 26
Paginas: 121-129
Archivo PDF: 250.15 Kb.

RESUMEN

Introducción: Además de su valor pronóstico en insuficiencia cardiaca, los PN han mostrado ser útiles en otros contextos clínicos. Ha sido descrito que pueden predecir la eficacia de la reperfusión tanto a nivel macro como microvascular, así como desenlaces clínicos en pacientes con IAMST. Objetivo: Determinar si un valor elevado de NT-pro-BNP previo a la angioplastia primaria en pacientes con IAMST se asocia a menor eficacia de la reperfusión, a resultados angiográficos adversos, a la presencia de obstrucción microvascular y a mayor mortalidad. Material y métodos: Se determinó el valor de NT-pro-BNP a los sujetos con IAMST previo a la angioplastia. Se hicieron dos grupos y se compararon las variables relacionadas con el éxito del tratamiento de reperfusión. Resultados: Se incluyeron 316 pacientes. Se encontró que un nivel de 1,382 pg/mL se asocia a mortalidad (AUC 0.727). Se dividió a los pacientes en dos grupos: Grupo 1, aquéllos con NT-pro-BNP menor a ese valor, y Grupo 2, aquéllos con NT-pro-BNP elevado. La mortalidad fue mayor en el segundo grupo. El flujo TMP 3 final fue mayor en el Grupo 1 (p = 0.01). La resolución completa de la elevación del ST fue mayor en el Grupo 1. La presencia de OMV fue significativamente mayor en el Grupo 2 (p ‹ 0.001). Un punto de corte de NT-pro-BNP de 252 pg/mL tuvo AUC 0.944 para OMV. Conclusiones: NT-pro-BNP elevado es un predictor de OMV, de FNR y de mayor riesgo.

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