B-type natriuretic peptide as a predictor of ischemia/reperfusion injury immediately after myocardial reperfusion in patients with ST-segment elevation acute myocardial infarction. Issue 1 (1st February 2016)

• Record Type: Journal Article
• Authors: Arakawa, Kentaro; Himeno, Hideo; Kirigaya, Jin; Otomo, Fumie; Matsushita, Kensuke; Nakahashi, Hidefumi; Shimizu, Satoru; Nitta, Manabu; Takamizawa, Tetsu; Yano, Hideto; Endo, Mitsuaki; Kanna, Masahiko; Kimura, Kazuo; Umemura, Satoshi
• Is Part Of: European heart journal. Volume 5:Issue 1(2016)
• Page Start: 62
• Page End: 70
• Publication Date: 2016-02-01
• Subjects: Ischemia reperfusion injury -- B-type natriuretic peptide -- myocardial infarction; 616.1205
• DOI: 10.1177/2048872615568964
• Languages: English
• ISSNs: 2048-8726

Abstract

Abstract: Background: In animal models of acute myocardial infarction (AMI), B-type natriuretic peptide (BNP) administered before and during coronary occlusion limits infarct size. However, the relation between plasma BNP levels and ischemia/reperfusion injury remains unclear. Methods: 302 patients with ST-segment elevation AMI (STEMI) received emergency percutaneous coronary intervention within six hours from the onset. The patients were divided into two groups according to the plasma BNP level before angiography: group L ( n =151), BNP ≤32.2 pg/ml; group H ( n =151), BNP >32.2 pg/ml. The Selvester QRS-scoring system was used to estimate infarct size. Results: The rate of ischemia/reperfusion injury immediately after reperfusion, defined as reperfusion ventricular arrhythmias (26% vs . 11%, p =0.001) and ST-segment re-elevation (44% vs . 22%, p =0.008), was higher in group L than in group H. Group L had a greater increase in the QRS score during percutaneous coronary intervention (3.55±0.17 vs . 2.09±0.17, p <0.001) and a higher QRS score 1 h after percutaneous coronary intervention (5.77±0.28 vs . 4.51±0.28, p =0.002). On multivariate analysis, plasma BNP levels in the lower 50th percentile were an independent predictor of reperfusion injury (odds ratio, 2.620; p <0.001). The odds ratios of reperfusion injury according to decreasing quartiles of BNP level, as compared with the highest quartile, were 1.536, 3.692 and 4.964, respectively ( p trend=0.002). Conclusions: Plasma BNP level before percutaneous coronary intervention may be a predictor of ischemia/reperfusion injury and the resultant extent of myocardial damage. Our findings suggest that high plasma BNP levels might have a clinically important protective effect on ischemic myocardium in patients with STEMI who receive percutaneous coronary intervention.