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Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction : insights from the APEX-AMI trial

van Diepen, Sean (författare)
Roe, Matthew T. (författare)
Lopes, Renato D. (författare)
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Stebbins, Amanda (författare)
James, Stefan (författare)
Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),kardiologi
Newby, L. Kristin (författare)
Moliterno, David J. (författare)
Neumann, Franz-Josef (författare)
Ezekowitz, Justin A. (författare)
Mahaffey, Kenneth W. (författare)
Hochman, Judith S. (författare)
Hamm, Christian W. (författare)
Armstrong, Paul W. (författare)
Theroux, Pierre (författare)
Granger, Christopher B. (författare)
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 (creator_code:org_t)
2012
2012
Engelska.
Ingår i: Journal of Thrombosis and Thrombolysis. - 0929-5305 .- 1573-742X. ; 34:1, s. 106-113
  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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  • Coronary plaque rupture is associated with a systemic inflammatory response. The relationship between baseline N-terminal pro B-type natriuretic peptide (NT-proBNP), a prognostic marker in patients with acute coronary syndromes, and systemic inflammatory mediators in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) is not well described. Of 5,745 STEMI patients treated with primary PCI in the APEX-AMI trial, we evaluated the relationship between baseline NT-proBNP levels and baseline levels of inflammatory markers and markers of myonecrosis in a subset of 772 who were enrolled in a biomarker substudy. Spearman correlations (r (s)) were calculated between baseline NT-proBNP levels and a panel of ten systemic inflammatory biomarkers. Interleukin (IL)-6, a pro-inflammatory cytokine, was significantly positively correlated with NT-proBNP (r (s) = 0.317, P < 0.001). In a sensitivity analysis excluding all heart failure patients, the correlation between baseline IL-6 and NT-proBNP remained significant (n = 651, r (s) = 0.296, P < 0.001). A positive association was also observed with high sensitivity C-reactive protein (r (s) = 0.377, P < 0.001) and there was a weak negative correlation with the anti-inflammatory cytokine IL-10 (r (s) = -0.109, P = 0.003). No other significant correlations were observed among the other testes inflammatory cytokines and chemokines. In STEMI patients undergoing primary PCI, the pro-inflammatory cytokine IL-6 was modestly correlated with baseline NT-proBNP levels. This relationship remained significant in patients without heart failure. This finding is consistent with pre-clinical and clinical research suggesting that systemic inflammation may influence NT-proBNP expression independently of myocardial stretch.

Nyckelord

N-terminal pro-brain natriuretic peptide
Interleukin-6
Interleukin-10
C-reactive protein

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