الفهرس 
Acute ST segment Elevation Myocardial InfarctionOnly 14 pages are availabe for public view
 |  | from | 16 |  |  |
| | | from | 16 | | |
Abstract
B
-type natriuretic peptide (BNP) is a 32-amino-acid polypeptide secreted by cardiac ventricles in response to increased stretch or wall tension. BNP is involved in the regulation of blood pressure, blood volume and sodium balance. Recent studies have shown that BNP is a useful biochemical marker for cardiac dysfunction. Levels of BNP also appear to be associated with the prognosis of patients with Acute coronary syndromes (ACS).
The aim of the study is to investigate the prognostic value of B type natriuretic peptide (BNP) in acute myocardial infarction patients and its correlation with left ventricular function and post-myocardial infarction complications in the in hospital period.
This study enrolled 90 consecutive patients admitted to coronary care units of Ain Shams University hospitals with acute ST segment elevation myocardial infarction who successfully reperfused by primary PCI or thrombolysis. The study was performed in the period from September 2014 to April 2015.
All patients were subjected to history intake, clinical examination, 12-lead surface ECG, laboratory measurements of BNP immediately after reperfusion an CK-MB level, trans-thoracic echocardiography on third day of admission and in hospital Clinical follow up for: any manifestations of heart failure, Killip class, cardiogenic shock, cardiac arrest, development of pericarditis & mortality, Daily ECG to detect the presence of any arrhythmias (Tachy or Brady) and Cardiac enzymes will be measured daily.
Exclusion Criteria includes: Valvular heart disease, Atrial Fibrillation, Pulmonary diseases such as COPD, Pulmonary Embolism, Pneumonia, Liver Cirrhosis, Hyperthyroidism and Acute renal failure.
A statistically significant positive correlation between BNP levels and age (P-value = 0.036), diabetes mellitus (P-value = 0.028) and hypertension (P-value = 0.019).
There was no statistically significant correlation between BNP levels and site of infarction with (P-value = 0.141).
As regard Echocardiography parameters there was significant negative correlation between BNP levels and ejection fraction with (P-value = 0.033) and cut off value of BNP <1170 pg/ml.
Patients with BNP level (≥1238.7 pg/ml) were significantly more likely to experience new or worsening heart failure with (P-value=0.035).
A statistically significant positive correlation between BNP levels and mechanical complications (mitral regurgitation) P-value = 0.050 with cut off value of BNP >1116 pg/ml and arrhythmias (ventricular tachycardia, complete heart block and atrial fibrillation) (P-value =0.002) with cut off value of BNP >1418 pg/ml.
Patients who were reperfused by streptokinase had higher levels of BNP than those who underwent primary PCI but there was no statistically significant correlation between BNP levels and type of reperfusion with (P-value =0.744).
Patients who underwent total revascularization had BNP levels higher than those who went intervention for culprit lesion only. There was significant positive correlation between BNP levels and total revascularization with (P-value = 0.028).