Objective: To investigate the differences of the B-type natriuretic peptide (BNP) levels in serum or plasma of the STEMI patients with different infarction sites. To explore the relationship between the BNP level and the short-term prognosis in patients with ST-segment elevation myocardial infarction (STEMI).
Patients and methods: A total of 216 STEMI patients were enrolled in this study from June 2012 to June 2014. All patients received coronary angiography (CAG). Based on electrocardiography (ECG) and CAG results, patients were divided into three groups. Group A included 80 patients with anterior/lateral wall myocardial infarction, group B included 76 patients with inferior/posterior wall myocardial infarction and group C included 60 patients with right ventricular myocardial infarction. We enrolled 53 patients with normal CAG results as Group D. BNP levels were compared among these groups. and according to BNP levels, all patients were subdivided into normal BNP group (< 100 ng/mL, n = 53), mild-higher BNP group (100-400 ng/mL, n = 105) and marked-higher BNP group (≥ 400 ng/mL, n = 58). The occurrence of major adverse cardiovascular events (MACE) including secondary heart failure, severe arrhythmia, post-infarction angina, recurrent myocardial infarction, and cardiac death within 6 months after disease onset were assessed.
Results: BNP levels showed a gradually decreasing trend in groups A, B, C and D (p < 0.05). Significant differences in left ventricular ejection fraction (LVEF) were found among normal BNP group, mild-high BNP group and marked-higher BNP group (p < 0.05). The MACE occurrence presented no statistical differences between normal BNP group and mild-higher BNP group (p > 0.05). The MACE prevalence in marked-higher BNP group was significantly higher than normal BNP group and mild-higher BNP group (p < 0.05).
Conclusions: BNP levels can be used as a clinical indicator to predict short-term prognosis in STEMI patients.