PMID- 20102879
OWN - NLM
STAT- MEDLINE
DCOM- 20100302
LR  - 20181201
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 159
IP  - 1
DP  - 2010 Jan
TI  - Plasma N-terminal fragment of the prohormone B-type natriuretic peptide 
      concentrations in relation to time to treatment and Thrombolysis in Myocardial 
      Infarction (TIMI) flow: a substudy of the Assessment of the Safety and Efficacy 
      of a New Treatment Strategy with Percutaneous Coronary Intervention (ASSENT 
      IV-PCI) trial.
PG  - 131-40
LID - 10.1016/j.ahj.2009.11.001 [doi]
AB  - BACKGROUND: We investigated the prognostic significance of plasma N-terminal 
      fragment of the prohormone B-type natriuretic peptide (Nt-proBNP) concentrations 
      in addition to time to reperfusion and Thrombolysis in Myocardial Infarction 
      (TIMI) flow before and after coronary intervention in patients with ST elevation 
      myocardial infarction (STEMI) from the database of the Assessment of the Safety 
      and Efficacy of a New Treatment Strategy with Percutaneous Coronary Intervention 
      (ASSENT IV-PCI) trial. METHODS: Plasma Nt-proBNP was available in 1,037 patients 
      with STEMI. Patients were randomized either to primary (p-PCI) or to full-dose 
      tenecteplase before PCI (f-PCI).The study end point was the composite of death, 
      cardiogenic shock, or congestive heart failure at 90 days. RESULTS: According to 
      classification tree analysis, patients with Nt-proBNP levels >694 pg/mL had the 
      highest primary end point rates (33.8% vs 11%, P < .001). In Cox regression 
      analysis, Nt-proBNP >694 pg/mL strongly predicted 90-day survival even among 
      patients with short treatment delay (f-PCI < or =3 hours: hazard ratio [HR] 2.63, 
      P = .002 and p-PCI < or =3 hours: HR 4.87, P < .001, respectively). Patients with 
      TIMI 3 flow after coronary intervention were at significantly higher risk of the 
      primary end point if admission Nt-proBNP exceeded 694 pg/mL (f-PCI: HR 2.88, P < 
      .001 and p-PCI: HR 3.84, P < .001, respectively). In multivariable analysis, 
      Nt-proBNP >694 pg/mL significantly (P = .001) predicted 90-day survival in 
      addition to age (P < .001), TIMI flow after PCI (P < .001), body mass index (P = 
      .026), anterior wall infarction (P = .035), and systolic blood pressure at 
      randomization (P = .036), respectively. CONCLUSION: Elevated plasma 
      concentrations of Nt-proBNP in the early phase of STEMI determine in-hospital and 
      90-day outcome after infarction irrespective of time to treatment and pre- or 
      postinterventional TIMI flow.
CI  - Copyright 2010 Mosby, Inc. All rights reserved.
FAU - Jarai, Rudolf
AU  - Jarai R
AD  - 3rd Department of Medicine, Cardiology and Emergency Medicine, Wilhelminen 
      Hospital, Vienna, Austria.
FAU - Huber, Kurt
AU  - Huber K
FAU - Bogaerts, Kris
AU  - Bogaerts K
FAU - Droogne, Walter
AU  - Droogne W
FAU - Ezekowitz, Justin
AU  - Ezekowitz J
FAU - Granger, Christopher B
AU  - Granger CB
FAU - Sinnaeve, Peter R
AU  - Sinnaeve PR
FAU - Ross, Allan M
AU  - Ross AM
FAU - Zeymer, Uwe
AU  - Zeymer U
FAU - Armstrong, Paul W
AU  - Armstrong PW
FAU - Van de Werf, Frans J
AU  - Van de Werf FJ
CN  - ASSENT IV-PCI investigators
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
RN  - 0 (Biomarkers)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - EC 3.4.21.68 (Tissue Plasminogen Activator)
RN  - WGD229O42W (Tenecteplase)
SB  - IM
MH  - Aged
MH  - Analysis of Variance
MH  - Angioplasty, Balloon, Coronary/*methods/mortality
MH  - Biomarkers/blood
MH  - Combined Modality Therapy
MH  - Confidence Intervals
MH  - Coronary Angiography/methods
MH  - Coronary Circulation/drug effects/physiology
MH  - Early Diagnosis
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Myocardial Infarction/blood/diagnostic imaging/mortality/*therapy
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Predictive Value of Tests
MH  - Probability
MH  - Prospective Studies
MH  - Risk Assessment
MH  - Survival Analysis
MH  - Tenecteplase
MH  - Thrombolytic Therapy/*methods
MH  - Time Factors
MH  - Tissue Plasminogen Activator/*therapeutic use
MH  - Treatment Outcome
MH  - Vascular Patency/drug effects/physiology
EDAT- 2010/01/28 06:00
MHDA- 2010/03/03 06:00
CRDT- 2010/01/28 06:00
PHST- 2009/06/15 00:00 [received]
PHST- 2009/11/03 00:00 [accepted]
PHST- 2010/01/28 06:00 [entrez]
PHST- 2010/01/28 06:00 [pubmed]
PHST- 2010/03/03 06:00 [medline]
AID - S0002-8703(09)00833-3 [pii]
AID - 10.1016/j.ahj.2009.11.001 [doi]
PST - ppublish
SO  - Am Heart J. 2010 Jan;159(1):131-40. doi: 10.1016/j.ahj.2009.11.001.