Correlation Between Plasma BNP And Hcy Levels With CTNI, CK-MB Concentration, The Degree Of Coronary Artery Disease And Cardiac Function In Acute STEMI Patients

Objective: To investigate the correlation between BNP and Hcy levels with c Tn I,CK-MB,the degree of coronary artery disease and cardiac function in acute STEMI patients,and analysis the risk factors of acute STEMI.Methods: 176 patients with acute STEMI in hosipital form Feb 2015 to Feb 2017 were selected as the research object,according to the results of plasma BNP peak detection was divided into observation group A(71 cases),observation group B(63 cases)and observation group C(42 cases).Recorded and compared the plasma levels of BNP level,Hcy level,cTNI concentration,CK-MB concentration,the degree of coronary artery disease and cardiac function between the three groups.Inclusion criteria:(1)Onset to admission time<12h;(2)All patients were diagnosed with CAG and UCG,all were examined by BNP,Hcy,cTNI,CK-MB and the clinical data were complete;(3)All patients signed informed consent and approved by the hospital ethics committee.Exclusion criteria:(1)The patient was allergic to contrast agents or anticoagulants;(2)Patients with liver and pancreas and other major organ lesions;(3)Patients with hematologic disease,valvular disease or infectious disease;(4)Patients had the history of chronic obstructive pulmonary disease or pulmonary hypertension.Results: The BNP,Hcy,cTNI,CK-MB of observation group A,B,C patients were significantly increased,LVEF were gradually decreased,and the different between each groups were significantly,which were statistically significant(P<0.05);The Killip grade,vascular lesions,lesion type,lesion type integral,coronary collateral circulation,left ventricular end pressure,TIMI flow grade of the three groups were statistically significant(P<0.05);The number of diseased vessels between the three groups was not statistically significant(P>0.05).The correlation between the plasma BNP level and cTNI,CK-MB,LVEDP concentration and coronary score were positively(the values of r were 0.702,0.738,0.696,0.483 respectitively,all P<0.05),and with LVEF was negatively(r =-0.655,P<0.05);The correlation between the plasma Hcy levels and cTNI,CK-MB,LVEDP concentration and coronary score were positively(the values of r were 0.681,0.716,0.613,0.545 respectitively,all P<0.05),and with LVEF was negativel(r=-0.626,P<0.05).Using Logistic regression analysis showed that in addition to smoking(OR= 1.865,95%CI:1.535~2.498),hypertension(OR=2.237,95%CI:1.251~2.913),diabetes(OR=3.216,95%CI:2.433~3.980),dyslipidemia(OR=4.248,95%CI:3.168~6.191),cTNI concentration(OR=1.259,95%CI:1.217~1.857),LVEF(OR= 1.24195%CI:0.953~1.387),plasma BNP level(OR=3.618,95%CI:2.338~4.413),plasma Hcy level(OR=2.042,95%CI:1.272~2.834)were independent risk factors of acute STEMI.Conclusion: With the increasing of plasma BNP and Hcy levels in patients with acute STEMI,the cTNI and CK-MB concentration increase significantly,the degree of coronary artery disease is increased and the cardiac function is worse,the levels of plasma Hcy and plasma BNP are independent risk factors of acute STEMI.