PMID- 16639474
OWN - NLM
STAT- MEDLINE
DCOM- 20060613
LR  - 20211020
IS  - 0828-282X (Print)
IS  - 1916-7075 (Electronic)
IS  - 0828-282X (Linking)
VI  - 22
IP  - 5
DP  - 2006 Apr
TI  - N-terminal pro-brain natriuretic peptide and the timing, extent and mortality in 
      ST elevation myocardial infarction.
PG  - 393-7
AB  - AIMS: While natriuretic peptides have demonstrated diagnostic and prognostic 
      potential in cardiac disorders, little is known about their relationship with the 
      onset and quantification of myocardial infarction. The relationship of serial 
      N-terminal pro-brain natriuretic peptide (NT-proBNP) with duration from symptom 
      onset, infarct size and prognosis in ST elevation myocardial infarction (STEMI) 
      patients treated with primary percutaneous intervention was examined. METHODS AND 
      RESULTS: Three hundred thirty-one STEMI patients in the COMplement inhibition in 
      Myocardial infarction treated with Angioplasty (COMMA) trial, which evaluated 
      pexelizumab versus placebo, were studied. NT-proBNP (pg/mL) was measured at 
      randomization, 24 h and 72 h; creatine kinase-MB area under the curve was 
      measured at 72 h; and QRS score was assessed at discharge. Prognosis was 
      ascertained from the 90-day composite clinical outcome of death, shock, stroke 
      and congestive heart failure. Multivariate logistical regression was used to 
      adjust for baseline characteristics for models at randomization, 24 h and 72 h. 
      NT-proBNP was higher in patients with longer time from symptom onset (P<0.001) 
      and correlated with measures of infarct size, including the area under the curve 
      (P<0.001) and QRS score (P<0.001). Patients reaching the primary end point had 
      markedly higher NT-proBNP at each sampling period (P<0.001). NT-proBNP at all 
      time points was the strongest independent predictor of the primary end point in 
      the multivariate model: in the 24 h model, only age and 24 h NT-proBNP (C-index 
      0.83); and only age, Killip class and NT-proBNP was in the 72 h model (C-index 
      0.85). CONCLUSIONS: Higher NT-proBNP at 24 h correlated with larger infarct size 
      and worse clinical outcomes. NT-proBNP at baseline, 24 h and 72 h after 
      presentation with acute STEMI, is an independent predictor of a poor outcome and 
      adds clinically useful prognostic information.
FAU - Ezekowitz, Justin A
AU  - Ezekowitz JA
AD  - University of Alberta, Edmonton, Canada.
FAU - Theroux, Pierre
AU  - Theroux P
FAU - Chang, Weiching
AU  - Chang W
FAU - Mahaffey, Kenneth W
AU  - Mahaffey KW
FAU - Granger, Christopher B
AU  - Granger CB
FAU - Weaver, W D
AU  - Weaver WD
FAU - Hochman, Judith S
AU  - Hochman JS
FAU - Armstrong, Paul W
AU  - Armstrong PW
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - Can J Cardiol
JT  - The Canadian journal of cardiology
JID - 8510280
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Age Distribution
MH  - Electrocardiography
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Myocardial Infarction/*blood/diagnosis/*mortality/therapy
MH  - Myocardial Reperfusion
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Prognosis
MH  - Sex Distribution
MH  - Survival Analysis
PMC - PMC2560534
EDAT- 2006/04/28 09:00
MHDA- 2006/06/14 09:00
PMCR- 2007/04/01
CRDT- 2006/04/28 09:00
PHST- 2006/04/28 09:00 [pubmed]
PHST- 2006/06/14 09:00 [medline]
PHST- 2006/04/28 09:00 [entrez]
PHST- 2007/04/01 00:00 [pmc-release]
AID - S0828-282X(06)70924-2 [pii]
AID - cjc220393 [pii]
AID - 10.1016/s0828-282x(06)70924-2 [doi]
PST - ppublish
SO  - Can J Cardiol. 2006 Apr;22(5):393-7. doi: 10.1016/s0828-282x(06)70924-2.