Change of BNP between admission and discharge after ST-elevation myocardial infarction (Killip I) improves risk prediction of heart failure, death, and recurrent myocardial infarction compared to single isolated measurement in addition to the GRACE score

Autor: Jose C. Quinaglia e Silva, Lauro Afonso C Bogniotti, Luiz Sergio F. Carvalho, Otávio Rizzi Coelho, Andrei C. Sposito, Osorio L.R. Almeida, Wilson Nadruz
Rok vydání: 2018
Předmět:
Decreased ejection fraction
medicine.medical_specialty
Time Factors
030204 cardiovascular system & hematology
Critical Care and Intensive Care Medicine
Sudden death
Risk Assessment
03 medical and health sciences
Electrocardiography
0302 clinical medicine
St elevation myocardial infarction
Recurrence
Internal medicine
Natriuretic Peptide
Brain
medicine
Humans
cardiovascular diseases
030212 general & internal medicine
Myocardial infarction
Prospective Studies
Heart Failure
Ejection fraction
business.industry
Incidence
Stroke Volume
General Medicine
medicine.disease
Brain natriuretic peptide
Prognosis
Patient Discharge
Survival Rate
Recurrent myocardial infarction
Heart failure
Cardiology
ST Elevation Myocardial Infarction
Cardiology and Cardiovascular Medicine
business
Biomarkers
Brazil
Follow-Up Studies
Zdroj: European heart journal. Acute cardiovascular care. 8(7)
ISSN: 2048-8734
Popis: Objective: In ST-elevation myocardial infarction, 7–15% of patients admitted as Killip I will develop symptomatic heart failure or decreased ejection fraction. However, available clinical scores do not predict the risk of severe outcomes well, such as heart failure, recurrent myocardial infarction, and sudden death in these Killip I individuals. Therefore, we evaluated whether one vs two measurements of BNP would improve prediction of adverse outcomes in addition to the GRACE score in ST-elevation myocardial infarction/Killip I individuals. Methods: Consecutive patients with ST-elevation myocardial infarction/Killip I ( n=167) were admitted and followed for 12 months. The GRACE score was calculated and plasma BNP levels were obtained in the first 12 h after symptom onset (D1) and at the fifth day (D5). Results: Fifteen percent of patients admitted as Killip I developed symptomatic heart failure and/or decreased ejection fraction in 12 months. The risk of developing symptomatic heart failure or ejection fraction Conclusions: Only BNP-change following myocardial infarction was associated with poorer short- and long-term outcomes. BNP-change also improves risk reclassification in addition to the GRACE score.
Databáze: OpenAIRE
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