Abstract 570: N-terminal Pro-brain Natriuretic Peptide And 6-month Mortality In Patients With Preserved Lv Systolic Function After Acute Myocardial Infarction
Background: It has been known that myocardial ischemia augments the synthesis and release of B-type natriuretic peptide (BNP). Although plasma BNP has been shown to provide prognostic information in patients with left ventricular (LV) dysfunction after acute myocardial infarction (AMI), few data are available for the patients with preserved LV systolic function. We investigated 6-month prognostic value of plasma N-terminal pro-BNP (NT-proBNP) in patients with preserved LV systolic function (LV ejection fraction (EF)> 50%) following AMI.
Methods: Between November 2005 and December 2006, 2607 eligible patients (1867 males and 740 females; mean age=63.0 ± 12.3 year-old) were analyzed in the Korea Acute Myocardial Infarction Registry (KAMIR), on-line prospective and observational registration carried out throughout 41 primary percutaneous coronary intervention (PCI) centers. We measured NT-proBNP at admission. The LVEF was measured by 2D echocardiography.
Results: Six-month mortality was 1.8% in patients with preserved LV systolic function after index AMI. Multivariate analysis showed log NT-proBNP (odds ratio [OR] 2.88, 95% confidence interval [CI] 1.14 to 7.26), antecedent diabetes (OR 7.86, 95% CI 2.05 to 30.07), body mass index (OR 0.58, 95% CI 0.39 to 0.86), systolic blood pressure (OR 0.95, 95% CI 0.91 to 0.99) were independent predictor of 6-month mortality after adjustment for age, weight, diastolic blood pressure, Killip class, previous ischemic heart disease, smoking status, PCI, drug therapy, and lipid profiles. Receiver operating characteristic (ROC) curve showed a best cut-off value of NT-proBNP to predict 6-month mortality was 938.5pg/mL with a sensitivity of 73.3% and a specificity of 70.9% (AUC = 0.784, p <0.001).
Conclusions: Plasma NT-proBNP is an independent predictor of 6-month mortality in patients with preserved LV systolic function following AMI.