The Clinical Significance Of Plasma B-type Natriuretic Peptide In Non-ST-segment Elevation Myocardial Infarction Patients

Background: The International Registration of data consistently show thatnon-ST-segment elevation acute coronary syndrome is more than ST-segment elevationacute coronary syndrome. The annual incidence of approximately3/1000residents ofcountries is slightly different. China’s large population, and severe aging.AlthoughST-segment elevation myocardial infarction in-hospital mortality is higher thannon-ST-segment elevation acute coronary syndrome (7%vs3-5%), but the6monthmortality rate is extremely close to both cases (respectively12%and13%) long-termfollow-up, non-ST-segment elevation acute coronary syndrome in patients with highermortality than ST-segment elevation acute coronary syndrome, two times four years.Non-ST-segment elevation acute coronary syndrome patients were older, more mergediseases, especially diabetes and renal failure. Non-ST-segment elevation acutecoronary syndrome treatment strategies not only for the acute phase, and the same alsoconcerned about the long-term treatment.2007American Heart Association (Americancolleges of of cardiology, ACC)/American Heart Association (American heartassociation.AHA) developed by UA and NSTEMI guidelines for the first time the BNPas a biochemical marker for evaluation of ACS overall cardiac risk. BNP has becomeacute coronary syndrome, a good diagnostic and prognostic markers, domestic studieshave shown that BNP level score and the GRACE (Global Registry of Acute CoronaryEvents) global acute coronary event registration)] are30days in patients with ACS theend of the risk predictor. Objective: To investigate venous blood B-type natriuretic peptide that the relationshipwith LDL, APOB and of CRP and FIB, Gensini score and the value of diagnosis andprognostic. In non-ST-segment elevation myocardial infarction.Methods161cases of clinically suspected NSTEMI in acute coronary syndrome,Combination of clinical symptoms the troponin I (ctni)≥0.15ug/L diagnosis of non STelevation myocardial infarction (NSTEMI)83patients.83patients undergoing electivecoronary angiography by clinical symptoms combined with Gensini score system toassess the degree of coronary stenosis. Combination of clinical symptoms the ctni,≥0.15ug/diagnosis of NSTEMI as a standard assessment of BNP≥100ng/L is thethreshold predict the diagnosis of NSTEMI sensitivity, specificity. Replacement of thenormal control group of20cases; in SAP group of20cases; UAP group of32cases;with STEMI group of27patients as the control. Study the relationship between BNPlevels and coronary heart disease risk factors of peripheral venous blood of TG, LDLand APOB and of CRP and FIB, Gensini ’score, age in83cases of patients withNSTEMI.30d major adverse cardiovascular events follow-up study of83cases ofNSTEMI patients, adverse events, including1.cardiac death2. Heart failure orcardiogenic shock. Postinfarction angina4. Recurrent myocardial infarction or stroke5.Arrhythmias after infarction. Compare the difference of BNP levels between thecardiovascular event group and the non-event group, and cardiovascular events riskfactors do logistic regression and ROC curve of BNP judgment Prognosis in patientswith NSTEMI.Results1.BNP level of coronary heart disease clinical classification the NSTEMIgroup> STEMI group> UAP group> SAP group> control group. Of BNP≥100ng/L threshold for early diagnosis and clinical symptoms combined with ctni diagnosis of NSTEMI compared with81.9%sensitivity,60.7%specificity, area under the ROCcurve was0.808(95%CI:0.739to0.877, p <0.05).(3) non-ST-segment elevationmyocardial infarction in patients with BNP levels Positive correlation with age，Gensini ’score and is no clear correlation with the LDL and TG, APOB and FIB andCRP levels. Cardiovascular events in patients with BNP levels were significantly higherthan in patients with non-cardiovascular events [(386.97±154.81) pg/ml, VS (200.50±112.87) pg/ml, p <0.05].5.BNP level to determine whether the occurrence ofcardiovascular events under the ROC curve area of0.866(95%CI:0.790~0.942, p<0.05).Conclusion: BNP level was significantly increased in the NSTEMI group of BNP aideddiagnosis for early diagnosis of NSTEMI. In patients with NSTEMI between BNP andage, Gensini score is Positive correlation and no clear correlation with other coronaryrisk factors. Independent predict cardiovascular events of patients with NSTEMI do notdepend on other risk factors.