脑利钠肽在预测心肌梗死冠状动脉疾病预后中的价值

Roja Qobadighadikolaei, Maryam Ekhlaspour, Mohammad Sistanizad, Roxana Sadeghi
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摘要

背景:脑利钠肽(BNP)是心衰患者预后的重要预测因子,但心肌梗死患者BNP升高的预后价值尚未完全确定。本研究旨在确定心肌梗死患者BNP变化的预后价值。方法:我们研究了在伊玛目侯赛因医院冠状动脉监护室住院的心肌梗死患者。住院期间记录患者的人口学资料、既往病史和用药史以及超声心动图报告和BNP水平,3个月后复查超声心动图。结果:这项前瞻性观察性横断面研究是在2018年1月至2019年1月期间进行的。在研究期间,124名患者被招募。BNP水平与射血分数(P=0.001)、收缩压(P= 0.012)、舒张压(P= 0.003)、二尖瓣早期流入速度与舒张早期二尖瓣环状速度之比(E/ E’)(P=0.03)及EF随访(P=0.001)呈显著负相关。BNP水平与梗死部位(P= 0.40)、左冠状动脉主干(P= 0.15)、左前降支(P=0.53)、左旋动脉(P= 0.97)、右冠状动脉(P=0.50)、医院(P= 0.66)的相关性均无统计学意义。结论:BNP是预测急性冠脉综合征患者预后及病情严重程度的重要指标。此外,它可以被认为是评估急性心肌梗死患者EF的预后长期指标。
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Value of brain natriuretic peptide in predicting prognosis of coronary artery disease in Myocardial infarction
Background:  Brain natriuretic peptide (BNP) is an important predictor of outcomes in patients with heart failure but the prognostic value of BNP elevation in patients with myocardial infarction is not (MI) incompletely defined. This study aims to identify the prognostic value of BNP changes in patients with MI. Methods: We studied patients with MI who were hospitalized in the Coronary Care Unit of Imam Hossein Hospital. Patients' demographic data, past medical and drug history besides echocardiography report and BNP levels were documented during the hospital stay and  echocardiography was repeated after 3 months. Results: This prospective observational cross-section study was done between January 2018 through January 2019. During the study period, 124 patients were recruited.. There were significant negative correlation between BNP levels and ejection fraction (P =0.001), systolic blood pressure (P =0.012), diastolic blood pressure (P =0.003) and ratio between early mitral inflow velocity and early diastolic mitral annular velocity (E/e') (P=0.03) and EF follow up (P=0.001). The correlation between BNP levels with infarction location (P =0.40), arterial involvement in the left main coronary artery ( P= 0.15), left anterior descending artery (P=0.53), left circumflex artery  (P= 0.97) ,right coronary artery (P=0.50) and hospital (P= 0.66) were not significant. Conclusion: BNP is a valuable marker for predicting prognosis and severity of coronary artery disease in patients with the acute coronary syndrome. Also, it could be considered as a prognostic long term marker for evaluating the EF of patients with AMI.
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