Study On The Predictive Value Of Admission BNP Level For Long-term Prognosis Of STEMI Patients

Objective: To analyze the predictive value of admission B-type natriuretic peptide(BNP)to the 3-year prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI)and related influencing factors.Methods: A total of 396 STEMI patients from the First Affiliated Hospital of Chongqing Medical University from January 2015 to December2017 were retrospectively divided into A(BNP <100pg / mL)and B group(100?BNP?400pg / mL))And Group C(400pg / mL <BNP),collect clinical data and prognostic data of the patients(re-hospitalization,re-PCI and all-cause death).The prognostic data of 396 patients were obtained through telephone and outpatient follow-up,with an average follow-up time of 36.7(15.2-52.0)months.This study conforms to the ethical standards of human experiment and has been approved by the ethics committee.Results: In the clinical data of patients in the three groups,the age of onset,the proportion of female patients,heart rate,the time from onset tooperation,and the proportion of heart failure increased with the increase of BNP(P<0.05).The proportion of smoking history and LVEF decreased with the increase of BNP(P<0.05).Among the admission symptoms,the proportion of chest distress/chest pain/crush was the largest,and decreased with the increase of BNP,while the other special manifestations increased with the increase of BNP.In Killip classification of cardiac function,grade I was the largest,but with the growth of BNP,the proportion of people with high-level cardiac function increased.The group C with the highest BNP prognosis had the highest all-cause mortality.COX regression analysis showed that age of onset,heart function grading in Killip and BNP could affect the prognosis of patients,with significant P values of 0.009,0.002 and 0.011,respectively.Kaplan-meier survival analysis showed that the final survival rate of different BNP groups was 95.3%,88.9% and 78.9%,respectively,among which the survival rate of group B without meeting the diagnostic criteria of acute heart failure was significantly lower than that of group A.Conclusion: The level of BNP at admission was closely related to the long-term all-cause mortality of STEMI patients,and BNP in the range of100-400pg/mL had some value in predicting the prognosis of STEMI patients...