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The Relationship among N-Terminal Pro-B-Type Natriuretic Peptide, High-Sensitivity C-Reactive Protein and Infarct Size in Patients with Acute ST-Elevation Myocardial Infarction

  • Sim, Doo Sun (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Ahn, Youngkeun (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Kim, Yun-Hyeon (Department of Radiology, Chonnam National University Hospital) ;
  • Seon, Hyun Ju (Department of Radiology, Chonnam National University Hospital) ;
  • Park, Keun Ho (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Yoon, Hyun Ju (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Yoon, Nam Sik (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Kim, Kye Hun (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Hong, Young Joon (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Park, Hyung Wook (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Kim, Ju Han (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Jeong, Myung Ho (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Cho, Jeong Gwan (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences) ;
  • Park, Jong Chun (Department of Cardiology, Cardiovascular Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences)
  • Received : 2014.09.29
  • Accepted : 2015.04.14
  • Published : 2015.07.30

Abstract

Background and Objectives: We sought to investigate the relationship between levels of high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and the infarct size and left ventricular (LV) volume after acute myocardial infarction (MI). Subjects and Methods: Eighty-six patients with acute ST-elevation MI underwent delayed enhancement multidetector computed tomography immediately after they underwent percutaneous coronary intervention to determine the infarct size. LV function and remodeling were assessed by echocardiography. Hs-CRP and NT-proBNP were measured at admission, 24 hours and two months later. Results: Both hs-CRP and NT-proBNP at 24 hours showed a positive correlation with infarct size and a negative correlation with LV ejection fraction at the baseline and two months later. NT-proBNP at two months correlated with infarct size, LV ejection fraction, and LV end diastolic and systolic volume indices at two months. In patients with high NT-proBNP levels at 24 hours and two months, infarct size was larger and LV ejection fraction was lower. NT-proBNP was higher in patients who developed LV remodeling at two months: 929 pg/mL vs. 134 pg/mL, p=0.002. In contrast, hs-CRP at two months showed no relationship to infarct size, LV function, or LV volumes at two months. Conclusion: Elevated hs-CRP level 24 hours after the onset of acute MI is associated with infarct size and LV dysfunction, whereas elevated levels of NT-proBNP 24 hours and two months after the onset of acute MI are both correlated with infarct size, LV dysfunction, and LV remodeling.

Keywords

Acknowledgement

Supported by : National Research Foundation of Korea

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