Association between on Admission Serum NT-pro BNP and ST-segment Resolution in Patients with Acute ST Elevated Myocardial Infarction undergoing Primary Percutaneous Coronary Intervention

Introduction: Post-percutaneous coronary interv2ntion (PCI) assessment of ST-segment resolution (STR) serves as a vital indicator of perfusion at heart micro vessels in patients with ST-segment elevation myocardial infarction (STEMI). NT-pro BNP emerges as a significant biomarker, aiding in risk stratification and prognostication in acute coronary syndrome. The aim of the study objective was to find out association between on admission N-terminal pro-B-type natriuretic peptide (NT-pro BNP) and ST-segment resolution and predicting about reperfusion before primary PCI.

Methods: This cross-sectional analytical study was carried out at national Heart Foundation Hospital & Research Institute (NHFH&RI) for one year from May 2023 to April 2024 involved 104 patients with STEMI who met the inclusion and exclusion criteria. A digital 12-lead ECG was recorded at admission and 60 minutes after primary PCI and blood samples were collected for NT-pro BNP. ST segment resolution ≥50% was considered as successful reperfusion and categorized as Group I, whereas STR<50% was considered failed reperfusion and categorized as Group II.

Results: Result revealed that maximum patient was in 51-60years age group (38.4%) and male predominant (86.5%). Diabetes mellitus (68.96%), hypertension (86.20%) and dyslipidemia (86.20%) were more in Group II. The mean (±SEM) NT-pro BNP level In Group I and group II was 385±53.47pg/ml and 6727±1286.39pg/ml respectively.  Notably, NT-pro-BNP ≥688pg/ml showed highest Youden Index with sensitivity of 86.2%, specificity of 85.3%, positive predictive value (PPV) of 69.44%, negative predictive value (NPV) of 94.12% and accuracy of 85.58% to predict failed ST resolution.  

Conclusions: NT-pro BNP level on admission is an important biomarker to predict ST resolution after Primary PCI.