| Title |
Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial
|
|---|---|
| Published in |
Journal of Thrombosis and Thrombolysis, February 2012
|
| DOI | 10.1007/s11239-012-0691-0 |
| Pubmed ID | |
| Authors |
Sean van Diepen, Matthew T. Roe, Renato D. Lopes, Amanda Stebbins, Stefan James, L. Kristin Newby, David J. Moliterno, Franz-Josef Neumann, Justin A. Ezekowitz, Kenneth W. Mahaffey, Judith S. Hochman, Christian W. Hamm, Paul W. Armstrong, Pierre Theroux, Christopher B. Granger |
| Abstract |
Coronary plaque rupture is associated with a systemic inflammatory response. The relationship between baseline N-terminal pro B-type natriuretic peptide (NT-proBNP), a prognostic marker in patients with acute coronary syndromes, and systemic inflammatory mediators in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) is not well described. Of 5,745 STEMI patients treated with primary PCI in the APEX-AMI trial, we evaluated the relationship between baseline NT-proBNP levels and baseline levels of inflammatory markers and markers of myonecrosis in a subset of 772 who were enrolled in a biomarker substudy. Spearman correlations (r (s)) were calculated between baseline NT-proBNP levels and a panel of ten systemic inflammatory biomarkers. Interleukin (IL)-6, a pro-inflammatory cytokine, was significantly positively correlated with NT-proBNP (r (s) = 0.317, P < 0.001). In a sensitivity analysis excluding all heart failure patients, the correlation between baseline IL-6 and NT-proBNP remained significant (n = 651, r (s) = 0.296, P < 0.001). A positive association was also observed with high sensitivity C-reactive protein (r (s) = 0.377, P < 0.001) and there was a weak negative correlation with the anti-inflammatory cytokine IL-10 (r (s) = -0.109, P = 0.003). No other significant correlations were observed among the other testes inflammatory cytokines and chemokines. In STEMI patients undergoing primary PCI, the pro-inflammatory cytokine IL-6 was modestly correlated with baseline NT-proBNP levels. This relationship remained significant in patients without heart failure. This finding is consistent with pre-clinical and clinical research suggesting that systemic inflammation may influence NT-proBNP expression independently of myocardial stretch. |
Mendeley readers
The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 3% |
| Sweden | 1 | 3% |
| Unknown | 38 | 95% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 8 | 20% |
| Student > Ph. D. Student | 6 | 15% |
| Professor | 4 | 10% |
| Other | 4 | 10% |
| Student > Postgraduate | 3 | 8% |
| Other | 9 | 23% |
| Unknown | 6 | 15% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 16 | 40% |
| Biochemistry, Genetics and Molecular Biology | 3 | 8% |
| Agricultural and Biological Sciences | 3 | 8% |
| Nursing and Health Professions | 2 | 5% |
| Computer Science | 2 | 5% |
| Other | 3 | 8% |
| Unknown | 11 | 28% |