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Use of B-type natriuretic peptide in evaluation of early percutaneous coronary intervention in patients with acute coronary syndrome
作者姓名:Jiang CY  Li N  Wang JA
作者单位:Department of Cardiology,Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China;Department of Cardiology,Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China;Department of Cardiology,Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
摘    要:Background Previous studies showed that blood B-type natriuretic peptide (BNP) level could predict the prognosis of acute coronary syndromes (ACS). This study investigated the evaluation value of circulating BNP for early percutaneous coronary intervention (PCI) in patients with ACS.Methods Nine hundred and sixty consecutive patients with ACS were enrolled. Circulating BNP level was measured when each patient arrived at the emergency room. All patients underwent PCI in 90 minutes in spite of contraindication. Cardiac events (death from any cause, heart failure, and recurrence of acute myocardial infarction or ACS) were recorded during follow-up. Results In patients with BNP ≥80 pg/ml, mortality from all causes within 1 month and 6 months in those underwent delayed PCI (≥6 hours) was significantly higher than those received early PCI (<6 hours) (9.53% vs 3.49%, P=0.027; 13.61% vs 5.24%, P=0.010, respectively). Similarly, the incidence rate of heart failure in delayed PCI patients was significantly higher than those received early PCI within 1 month and 6 months (12.93% vs 4.66%, P=0.008; 14.97% vs 6.98%, P=0.021, respectively). The recurrence rate of acute myocardial infarction or ACS, however, was not significantly different between early PCI and delayed PCI patients in group BNP ≥80 pg/ml. In patients with BNP <80 pg/ml, no significant difference was observed between early PCI and delayed PCI patients with any of the above cardiac events within 1 month or 6 months. Conclusion While early level of circulating BNP ≥80 pg/ml, the incidence of mortality and heart failure, but not recurrence of acute myocardial infarction, is significantly reduced in patients with ACS provided by early PCI.

关 键 词:B-型尿钠排泄胃蛋白酶  缩氨酸  早期  经皮作用  冠状动脉  急性冠状动脉病  PCI  ACS

Use of B-type natriuretic peptide in evaluation of early percutaneous coronary intervention in patients with acute coronary syndrome
Jiang CY,Li N,Wang JA.Use of B-type natriuretic peptide in evaluation of early percutaneous coronary intervention in patients with acute coronary syndrome[J].Chinese Medical Journal,2004,117(8):1130-1134.
Authors:Jiang Chen-yang  Li Nan  Wang Jian-an
Institution:Department of Cardiology,Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, China
Abstract:BACKGROUND: Previous studies showed that blood B-type natriuretic peptide (BNP) level could predict the prognosis of acute coronary syndromes (ACS). This study investigated the evaluation value of circulating BNP for early percutaneous coronary intervention (PCI) in patients with ACS. METHODS: Nine hundred and sixty consecutive patients with ACS were enrolled. Circulating BNP level was measured when each patient arrived at the emergency room. All patients underwent PCI in 90 minutes in spite of contraindication. Cardiac events (death from any cause, heart failure, and recurrence of acute myocardial infarction or ACS) were recorded during follow-up. RESULTS: In patients with BNP > or = 80 pg/ml, mortality from all causes within 1 month and 6 months in those underwent delayed PCI (> or = 6 hours) was significantly higher than those received early PCI (< 6 hours) (9.53% vs 3.49%, P = 0.027; 13.61% vs 5.24%, P = 0.010, respectively). Similarly, the incidence rate of heart failure in delayed PCI patients was significantly higher than those received early PCI within 1 month and 6 months (12.93% vs 4.66%, P = 0.008; 14.97% vs 6.98%, P = 0.021, respectively). The recurrence rate of acute myocardial infarction or ACS, however, was not significantly different between early PCI and delayed PCI patients in group BNP > or = 80 pg/ml. In patients with BNP < 80 pg/ml, no significant difference was observed between early PCI and delayed PCI patients with any of the above cardiac events within 1 month or 6 months. CONCLUSION: While early level of circulating BNP > or = 80 pg/ml, the incidence of mortality and heart failure, but not recurrence of acute myocardial infarction, is significantly reduced in patients with ACS provided by early PCI.
Keywords:B-type natriuretic peptide  acute coronary syndromes  percutaneous coronary intervention
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