Predictive value of the serum level of N-terminal pro-brain natriuretic peptide and high-sensitivity C-reactive protein in left ventricular remodeling after acute myocardial infarction

Hu Xiaozhou, Zhang Jie, Zhenrong Li, Cui Liyan
Journal of Clinical Laboratory Analysis 2006, 20 (1): 19-22
This study was designed to measure the correlation between left ventricular (LV) remodeling 3 months after successful reperfusion therapy, and the levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) at 3 days after acute myocardial infarction (AMI), and to determine the predictive levels of NT-proBNP and hs-CRP for LV remodeling. A total of 106 patients with first AMI were included in this study. Each patient was examined by echocardiography (ECG) on the third day and third month after AMI, and LV remodeling was determined by the difference in the LEV end-diastolic volume (LVEDV) between the third day and the third month. Serum NT-proBNP and hs-CRP level were measured 3 days after AMI. Then the correlation between the 3-months change in LVEDV and the levels of serum NT-proBNP or hs-CRP was determined. In addition, sensitivity and specificity were calculated with a receiver operating characteristic (ROC) curve to identify correspondence with LV remodeling (defined as the change rate of LVEDV >20%). Our results showed that the correlation coefficients with the change of LVEDV were 0.706 for serum NT-pro BNP (P<0.001) and 0.596 for hs-CRP (P<0.05). With a cutoff value of 0.2, the area under the ROC curve (AUC) was 0.894 for NT-proBNP and 0.825 for hs-CRP. Although the AUC did not statistically differ between NT-proBNP and hs-CRP, NT-proBNP is more effective than serum hs-CRP as a marker to predict LV remodeling.

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