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KMID : 0368120150450040285
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Korean Circulation Journal
2015 Volume.45 No. 4 p.285 ~ p.293
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The Relationship among N-Terminal Pro-B-Type Natriuretic Peptide, High-Sensitivity C-Reactive Protein and Infarct Size in Patients with Acute ST-Elevation Myocardial Infarction
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Sim Doo-Sun
Ahn Young-Keun
Kim Yun-Hyeon
Seon Hyun-Ju
Park Keun-Ho
Yoon Hyun-Ju
Yoon Nam-Sik
Kim Kye-Hun
Hong Young-Joon
Park Hyung-Wook
Kim Ju-Han
Jeong Myung-Ho
Cho Jeong-Gwan
Park Jong-Chun
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Abstract
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Background and Objectives: We sought to investigate the relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the infarct size and left ventricular (LV) volume after acute myocardial infarction (MI).
Subjects and Methods: Eighty-six patients with acute ST-elevation MI underwent delayed enhancement multidetector computed tomography immediately after they underwent percutaneous coronary intervention to determine the infarct size. LV function and remodeling were assessed by echocardiography. Hs-CRP and NT-proBNP were measured at admission, 24 hours and two months later.
Results: Both hs-CRP and NT-proBNP at 24 hours showed a positive correlation with infarct size and a negative correlation with LV ejection fraction at the baseline and two months later. NT-proBNP at two months correlated with infarct size, LV ejection fraction, and LV end diastolic and systolic volume indices at two months. In patients with high NT-proBNP levels at 24 hours and two months, infarct size was larger and LV ejection fraction was lower. NT-proBNP was higher in patients who developed LV remodeling at two months: 929 pg/mL vs. 134 pg/mL, p=0.002. In contrast, hs-CRP at two months showed no relationship to infarct size, LV function, or LV volumes at two months.
Conclusion: Elevated hs-CRP level 24 hours after the onset of acute MI is associated with infarct size and LV dysfunction, whereas elevated levels of NT-proBNP 24 hours and two months after the onset of acute MI are both correlated with infarct size, LV dysfunction, and LV remodeling.
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KEYWORD
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Myocardial infarction, Multidetector computed tomography, C-reactive protein, Pro-brain natriuretic peptide (1-76)
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