Suboptimal Final TIMIFlow after Primary Percutaneous Coronary Intervention for ST segment Elevation Myocardial Infarction: Impact on Brain Natriuretic Peptide

Abstract

Brain nariuretic peptide (BNP) and N-terminal pre-natriuretic has gained a great deal of attention in recent years and became an area of intense research as available bio marker in evaluating heart diseases since its physiological release has been related to condition that inflict astressful load on the heart, using BNP as biomarker is a routine practice in many centers around the world. Higher levels of brain natriuretic peptide(BNP) and N- terminal pro-natriuretic peptide (NT-pro BNP) in the first few days after AMI is a powerful predictor of left ventricle dysfunction,prognosis in heart failure and death (Omland et al., 1996). A group of patients with diagnosed ST elevation MI were subjected to history, examination, ECG, routine laboratory test, and blood sampling for BNP level on admission, patients underwentprimary percutaneous intervention for revascularization. BNP sample was drawn at 24 hours post cath and 48 hours. BNP level was higher in all patient on admission with different peaks. Level of BNP subsided post PCI in patients who achieved optimal flow (grade 3)with a cut off value equal or less than 40 pg/ml at which TIMI flow improved, while other group who achieved suboptimal flow (grade 1-2) had higher levels of BNP beyond 48h. LVEF in both groups (optimal and suboptimal flow post PCI) was inversely correlated with BNP levelwhich wasconfirmed by 2Decho examination.