2016, Number S3
NT-pro-BNP as a predictor of microvascular obstruction and high risk among patients taken to primary PCI
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Language: Spanish
References: 26
Page: 121-129
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ABSTRACT
Introduction: Besides its prognostic role in heart failure, natriuretic peptides are useful in other clinical scenarios. It has been described that they can predict macrovascular and microvascular reperfusion, and also clinical outcomes in patients with STEMI. Objective: To determine if an elevated NT-pro-BNP value measured before primary angioplasty among patients with STEMI is associated with an unsuccessful reperfusion, worse angiographic outcomes, presence of microvascular obstruction or higher mortality. Material and methods: We measured NT-pro-BNP before PCI to those patients who presented with STEMI. On the basis of NT-pro-BNP value we made two groups and compared variables related to successful reperfusion. Results: We included 316 subjects. We found that a cut-point of 1,382 pg/mL was related to mortality (AUC 0.727). We made two groups: Group 1, those with NT-pro-BNP below that level, and Group 2, those with NT-pro-BNP above it. Mortality was higher in the second group. TMP grade 3 and ST resolution were more frequent in Group 1. Microvascular obstruction had a strong association with a higher NT-pro-BNP level (p ‹ 0.001). A cut-point of 252 pg/mL showed an AUC of 0.944 for microvascular obstruction. Conclusions: An elevated NT-pro-BNP level can predict microvascular obstruction, no-reflow phenomenon and higher mortality.REFERENCES
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