Clinical InvestigationB-type natriuretic peptide molecular forms for risk stratification and prediction of outcome after acute myocardial infarction
Section snippets
Study population
One thousand and seventy-eight patients were admitted with acute MI to University Hospitals of Leicester, UK, between August 2004 and April 2007. Each patient consented (informed and written) to have blood samples taken and outcomes surveyed. This study was approved by the local ethics committee and adhered to the Declaration of Helsinki.
Diagnosis of acute MI was made on the basis that all patients had a cardiac troponin I (cTnI) concentration above the 99th percentile, with at least one of the
Patient characteristics
Plasma samples from 1078 patients admitted to hospital with acute MI were analyzed for the presence of BNP molecular forms. Mass spectral peaks for BNP molecular forms were detected in a total of 617 (57.2%) samples. A breakdown of the measured end points and clinical demographics for the patient cohort is shown in Table I.
Analyses with associated clinical measurements and outcomes
Spearman's rank-order correlation analyses showed clinical variables that were associated with one or more of the BNP molecular forms to be blood urea, eGFR, age, cTnI at
Discussion
This study reports that molecular forms of BNP are associated with poor outcome in patients hospitalized with acute MI, and the utility of these molecular forms in clinical risk prediction. The results showed that molecular BNP forms 5–32, 4–32 and 3–32 were all independently able to predict death/MI, death/HF and MACE at 6 months, 1 year and at 2 years after adjustment for traditional clinical and physiological factors. These prognostic qualities were comparable to conventional measurements of
Disclosures
The authors have no disclosures.
Acknowledgements
The authors are grateful to Sekisui Medical Co. for provision of antibodies and RapidPIA™ BNP kits.
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Conflicts of interest: The authors declare no conflicts of interest.
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LLN and TS contributed equally to this manuscript.