Coronary Aneurysm/complications

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Letter to the Editor

How to Approach Elevated NT-pro BNP Level on Admission to Prevent Left Ventricular Aneurysm Following Acute ST-Segment Elevation Myocardial Infarction

I have read with great interest the article written by Celebi and colleagues, demonstrating that elevated plasma N-terminal pro-B-type natriuretic peptide (NT-pro BNP) level on admission is a significant predictive biomarker of development of left ventricular aneurysm following acute ST-segment elevation myocardial infarction (STEMI) in the current era.

Their findings are straightforward and would lead us the next concerns. The first concern is reversibility of NT-pro BNP and its impact on post-STEMI outcomes. Is the reduction of NT-pro BNP following STEMI associated with a lower rate of left ventricular aneurysm formation?

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Original Article

The Usefulness of Admission Plasma NT-pro BNP Level to Predict Left Ventricular Aneurysm Formation after Acute ST-Segment Elevation Myocardial Infarction

Savas Celebi et al. Ozlem Ozcan Celebi Serkan Cetin Hande Ozcan Cetin … Mujgan Tek Serkan Gokaslan Basri Amasyali Berkten Berkalp Erdem Diker Sinan Aydogdu

Abstract

Background:

Left ventricular aneurysm (LVA) is an important complication of acute myocardial infarction. In this study, we investigated the role of N- Terminal pro B type natriuretic peptide level to predict the LVA development after acute ST-segment elevation myocardial infarction (STEMI).

Methods:

We prospectively enrolled 1519 consecutive patients with STEMI. Patients were divided into two groups according to LVA development within the six months after index myocardial infarction. Patients with or without LVAs were examined to determine if a significant relationship existed between the baseline N- Terminal pro B type natriuretic peptide values and clinical characteristics. A p-value < 0.05 was considered statistically significant.

Results:

LVA was detected in 157 patients (10.3%). The baseline N- Terminal pro- B type natriuretic peptide level was significantly higher in patients who developed LVA after acute MI (523.5 ± 231.1 pg/mL vs. 192.3 ± 176.6 pg/mL, respectively, p 65 y, smoking, Killip class > 2, previous coronary artery bypass graft, post-myocardial infarction heart failure, left ventricular ejection fraction 400 pg/mL at admission.

Conclusions:

Our findings indicate that plasma N- Terminal pro B type natriuretic peptide level at admission among other variables provides valuable predictive information regarding the development of LVA after acute STEMI.