PMID- 27887720
OWN - NLM
STAT- MEDLINE
DCOM- 20171130
LR  - 20180524
IS  - 1532-8430 (Electronic)
IS  - 0022-0736 (Linking)
VI  - 50
IP  - 1
DP  - 2017 Jan-Feb
TI  - Prehospital electrocardiographic acuteness score of ischemia is inversely 
      associated with neurohormonal activation in STEMI patients with severe ischemia.
PG  - 90-96
LID - S0022-0736(16)30285-0 [pii]
LID - 10.1016/j.jelectrocard.2016.11.002 [doi]
AB  - BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide 
      (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation 
      myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score 
      (based on the electrocardiographic score by Anderson-Wilkins acuteness score of 
      myocardial ischemia) is associated with increasing NT-proBNP levels and the 
      impact of decreasing acuteness-score on NT-proBNP levels is substantial in STEMI 
      patients with severe ischemia. METHODS: In 186 STEMI patients treated with 
      primary percutaneous coronary intervention (pPCI), the severity of ischemia 
      (according to Sclarovsky-Birnbaum severity grades of ischemia) and the 
      acuteness-score were obtained from prehospital ECG. Patients were classified 
      according to the presence of severe ischemia or non-severe ischemia and acute 
      ischemia or non-acute ischemia. Plasma NT-proBNP (pmol/L) was obtained after pPCI 
      within 24hours of admission and was correlated with the acuteness-score. RESULTS: 
      NT-proBNP levels were median (25th-75th interquartile) 112 (51-219) pmol/L in 
      patients with non-severe ischemia (71.5%) and 145 (79-339) in patients with 
      severe ischemia (28.5%) (p=0.074). NT-proBNP levels were highest in patients with 
      severe and non-acute ischemia compared to those with severe and acute ischemia 
      (182 (98-339) pmol/L vs 105 (28-324) pmol/L, p=0.012). There was a negative 
      correlation between acuteness-score and log(NT-proBNP) in patients with severe 
      ischemia (r=0.395, p=0.003), which remained significant in multilinear regression 
      analysis (beta=-0.155, p=0.007). No correlation was observed between the 
      acuteness-score and log(NT-proBNP) in patients with non-severe ischemia (p=0.529) 
      or in the entire population (p=0.187). CONCLUSION: In STEMI patients with severe 
      ischemia, neurohormonal activation is inversely associated with ECG patterns of 
      acute myocardial ischemia.
CI  - Copyright (c) 2016 Elsevier Inc. All rights reserved.
FAU - Fakhri, Yama
AU  - Fakhri Y
AD  - Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, 
      Denmark; Department of Medicine, Division of Cardiology, Nykobing F Hospital, 
      Nykobing F, Denmark. Electronic address: yfakhri@gmail.com.
FAU - Schoos, Mikkel Malby
AU  - Schoos MM
AD  - Department of Cardiology, Zealand University Hospital, Denmark.
FAU - Sejersten, Maria
AU  - Sejersten M
AD  - Department of Cardiology, Herlev University Hospital, Herlev, Denmark.
FAU - Ersboll, Mads
AU  - Ersboll M
AD  - Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, 
      Denmark.
FAU - Valeur, Nana
AU  - Valeur N
AD  - Department of Cardiology, Bispebjerg Hospital, Copenhagen, Denmark.
FAU - Kober, Lars
AU  - Kober L
AD  - Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, 
      Denmark.
FAU - Hassager, Christian
AU  - Hassager C
AD  - Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, 
      Denmark.
FAU - Wagner, Galen S
AU  - Wagner GS
AD  - Department of Medicine, Duke University Medical Center, Durham, NC, USA.
FAU - Kastrup, Jens
AU  - Kastrup J
AD  - Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, 
      Denmark.
FAU - Clemmensen, Peter
AU  - Clemmensen P
AD  - Department of Medicine, Division of Cardiology, Nykobing F Hospital, Nykobing F, 
      Denmark; Institute of Regional Health Research, University of Southern Denmark, 
      Odense, Denmark; Department of General and Interventional Cardiology, University 
      Heart Center Hamburg-Eppendorf, Hamburg, Germany.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20161110
PL  - United States
TA  - J Electrocardiol
JT  - Journal of electrocardiology
JID - 0153605
RN  - 0 (Biomarkers)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
SB  - IM
MH  - Acute Disease
MH  - Biomarkers/blood
MH  - Denmark
MH  - Electrocardiography/*methods/statistics & numerical data
MH  - Emergency Medical Services/*statistics & numerical data
MH  - Female
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Middle Aged
MH  - Myocardial Ischemia/blood/*diagnosis/*epidemiology
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Reproducibility of Results
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - ST Elevation Myocardial Infarction/blood/*diagnosis/*epidemiology
MH  - Sensitivity and Specificity
MH  - Severity of Illness Index
OTO - NOTNLM
OT  - Acuteness score
OT  - Ischemia
OT  - Neurohormonal activation
OT  - STEMI patients
EDAT- 2016/11/27 06:00
MHDA- 2017/12/01 06:00
CRDT- 2016/11/27 06:00
PHST- 2016/08/17 00:00 [received]
PHST- 2016/11/27 06:00 [pubmed]
PHST- 2017/12/01 06:00 [medline]
PHST- 2016/11/27 06:00 [entrez]
AID - S0022-0736(16)30285-0 [pii]
AID - 10.1016/j.jelectrocard.2016.11.002 [doi]
PST - ppublish
SO  - J Electrocardiol. 2017 Jan-Feb;50(1):90-96. doi: 
      10.1016/j.jelectrocard.2016.11.002. Epub 2016 Nov 10.