الفهرس 
Types of cardiac biomarkersOnly 14 pages are availabe for public view
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Abstract
B-type natriuretic peptide (BNP) is released from the cardiac ventricles in response to increased wall stress ( 129).
It has emerged as an aid to diagnosing congestive heart failure (CHF)(130) and has subsequently been studied in the setting of acute coronary syndromes, where the plasma concentration rises rapidly over 24 h after ST-segment elevation myocardial infarction (STEMI)(131,132,133).
There are sparse data addressing the prognostic implications of BNP drawn at the time of presentation with STEMI(132).
-Few data are available about early detection of serum BNP levels as a predictor for short term outcome in patients with ST elevation myocardial infarction and treated by primary PCI.
-We hypothesize that early detection of serum BNP level may identify patients at high risk for development of adverse clinical and angiographic results after primary PCI.
- In this setting, routine treatment, with after load reducing agents or novel agents that may improve infarct healing or ventricular remodeling after MI, may be particularly beneficial.
-We thus evaluated the prognostic performance , clinical and angiographic correlates of BNP, among patients with STEMI treated by primary PCI in 50 patients admitted at ain shams university hospitals by STEMI and underwent primary PCI as a reperfusion strategy.
-Each patient was subjected to (history taking ,clinical examination , laboratory investigations including withdrawal of serum samples for detection of BNP levels using BNP Enzyme Immunoassay (EIA) kit , echocardiography , assessment of the angiography results of the primary PCI using TIMI flow grade and myocardial blush grade )
-Follow up of the patients after one month for rehospitalization development of new ischemic events , development of heart failure and the need for revascularization.
-In this study we found significant correlation between serum BNP levels and LV systolic dysfunction ( EF less than 50% ) (P = 0.05 ) , we found also that serum BNP levels equal to or more than 225 had a sensitivity of 60% and specificity of 61% for prediction of patients with LV systolic dysfunction ( P 0.042 ).
-also we found significant correlation between serum BNP levels and the site of myocardial ischemic territory with higher levels in patients with LAD culprit lesions and anterior wall myocardial infarction ( P = 0.033 ).
- The current study also confirms serum BNP as a predictor of heart failure development during the hospital stay ( P = 0.048) and during the follow up period ( P = 0.042 ).
-This study failed to find significant correlation between serum BNP levels and the risk factors of the patients, their killip class at time of admission ,the ST segment resolution in the ECG after primary PCI , the final angiographic results and the prediction of recurrent ischemic attacks ,mortality and the need for revascularization during the follow up period.