Effect Of Body Mass Index(BMI) On The Plasma Levels Of NT-proBNP In Patients With St-segment Elevation Myocardial Infarction(STEMI) And Medication Guidance

Objective:Obesity is a well-known risk factor for cardiac metabolic diseases,but The influence of obesity in patients with STEMI is not clear.The objective of this paper is to investigate the effect of Body Mass Index(BMI)on the plasma levels of NT-proBNP in patients with ST-segment elevation myocardial infarction(STEMI)and to help clinical pharmacist give medication guidance.Methods:1.453 patients with STEMI were enrolled from March 2013 to December 2016,their age of 26-92 years,mean age is(61.49 ± 0.5578)years,among them 283 patients more than 65 years,170 under 65 years,324 male,129 females,199 Killip Class I,254 Killip Class II,who were admitted in cardiology department of the Affilicate Hospital of Yanbian University.Sex,age,BMI and history of hypertension,diabetes,smoking were recorded.And blood lipid examination,plasma levels of NT-proBNP,Killip Class were recorded.2.The plasma levels of NT-proBNP in all subjects were measured by colloidal gold method.GraphPad Prism 5.0 medical statistics software was used to statistics.All data were expressed by(Mean±standard error).As NT-proBNP numerical value was big,LogNT-proBNP was used.Pearson X2 test was used for Constitution ratio of two samples.Comparison between groups,according to the sample distribution discretionary analysis:independent sample t-test was adopted as normal distribution,when skewness distribution using Wilcoxon rank and inspection.Linear regression equation was used for further study of the linear relation between BMI and LogNT-proBNP.Results:1.Plasma NT-proBNP concentration in STEMI Killip Class ? obesity patients was(772±86.2)pg/ml,normal weight patients was(1488±145.7)pg/ml,comparing two groups of plasma NT-proBNP average concentration,difference was statistically significant(P=0.0002);Plasma NT-proBNP concentration in STEMI Killip Class ?obesity patients was(1445±145.7)pg/ml,normal weight patients was(2095±160.6)pg/ml,comparing two groups of plasma NT-proBNP average concentration,difference was statistically significant(P=0.0002).2.To contrast obesity and the normal weight patients average age,the average age of STEMI Killip Class ? obesity patients was(55.52±1.330)years old,normal weight patients was(62.10±1.02,P<0.0001);the average age of STEMI Killip Class?obesity patients was(59.01±0.9694)years old,normal weight patients was(67.09±0.9345,P<0.0001).3.According the linear regression result:a negative correlation was found between BMI and plasma NT-proBNP concentration in STEMI Killip Class ?patients(R2=0.05922,P<0.0001);in STEMI Killip Class ? patients,the negative correlation was also found between BMI and Plasma NT-proBNP concentration(R2=0.0.03268,P=0.0038).BMI has significant linear relation with plasma NT-proBNP concentration in STEMI Killip Class I and Class ? patients.4.Clinical pharmacists according the results do individualized medication guide for obese STEMI patients.Conclusion:1.Obesity patients plasma NT-proBNP concentration was significantly lower than patients with normal body weight in STEMI Killip Class I and Class ?patients.Negatively correlated with BMI and plasma NT-proBNP concentration,with the increased BMI,plasma NT-proBNP concentration decreased.2.In STEMI Killip Class I and Class II patients,obesity patients was younger than normal body weight group.3.Medication guideline could be administered according to the possible effects of obesity on the drug.