Korean Circ J.  2015 Jul;45(4):285-293. 10.4070/kcj.2015.45.4.285.

The Relationship among N-Terminal Pro-B-Type Natriuretic Peptide, High-Sensitivity C-Reactive Protein and Infarct Size in Patients with Acute ST-Elevation Myocardial Infarction

• Sim DS
• Ahn Y
• Kim YH
• Seon HJ
• Park KH
• Yoon HJ
• Yoon NS
• Kim KH
• Hong YJ
• Park HW
• Kim JH
• Jeong MH
• Cho JG
• Park JC

• KMID: 1964100
• DOI: http://doi.org/10.4070/kcj.2015.45.4.285

Abstract

BACKGROUND AND OBJECTIVES
We sought to investigate the relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the infarct size and left ventricular (LV) volume after acute myocardial infarction (MI).
SUBJECTS AND METHODS
Eighty-six patients with acute ST-elevation MI underwent delayed enhancement multidetector computed tomography immediately after they underwent percutaneous coronary intervention to determine the infarct size. LV function and remodeling were assessed by echocardiography. Hs-CRP and NT-proBNP were measured at admission, 24 hours and two months later.
RESULTS
Both hs-CRP and NT-proBNP at 24 hours showed a positive correlation with infarct size and a negative correlation with LV ejection fraction at the baseline and two months later. NT-proBNP at two months correlated with infarct size, LV ejection fraction, and LV end diastolic and systolic volume indices at two months. In patients with high NT-proBNP levels at 24 hours and two months, infarct size was larger and LV ejection fraction was lower. NT-proBNP was higher in patients who developed LV remodeling at two months: 929 pg/mL vs. 134 pg/mL, p=0.002. In contrast, hs-CRP at two months showed no relationship to infarct size, LV function, or LV volumes at two months.
CONCLUSION
Elevated hs-CRP level 24 hours after the onset of acute MI is associated with infarct size and LV dysfunction, whereas elevated levels of NT-proBNP 24 hours and two months after the onset of acute MI are both correlated with infarct size, LV dysfunction, and LV remodeling.

Keyword

Myocardial infarction; Multidetector computed tomography; C-reactive protein; Pro-brain natriuretic peptide (1-76)

MeSH Terms

C-Reactive Protein*
Echocardiography
Humans
Multidetector Computed Tomography
Myocardial Infarction*
Percutaneous Coronary Intervention
C-Reactive Protein

Figure

• 

  Fig. 1 Scheme of the study protocol. CK: creatine kinase, CKMB: creatine-kinase MB, Tn-I/T: troponin-I/T, hs-CRP: high-sensitivity C-reactive protein, NT-proBNP: N-terminal pro-B-type natriuretic peptide, DE MDCT: delayed enhancement multidector computed tomography, PCI: percutaneous coronary intervention, 2DE: two-dimensional echocardiography, CTFC: corrected Thrombolysis In Myocardial Infarction frame count, TMPG: Thrombolysis In Myocardial Infarction myocardial perfusion grade, MBG: myocardial blush grade, ECG: electrocardiogram.

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