Changes of natriuretic peptides concentration in early phase of acute myocardial infarction.

AIM To analyze a change of level of nautriuretic peptide (NT pro- BNP) caused by stress distension of myocardial wall in cases of acute myocardial infarction (AIM), as a possible predictor of early heart failure. METHODS Patients with myocardial infarction were followed up. Standard clinical and laboratory examination, including NT pro- BNP, and other laboratory analyses, were performed on the day of admission, the next day and on the eighth day of hospitalization. Statistical analyses included variance for repeated measurement (ANOVA), factorial multivariate analysis and test of multiple correlations. RESULTS The most important predictors of early heart failure in acute myocardial infarction were age, diastolic blood pressure, creatin kinase (CK) on admission, larger field of infarction zone and so on. Multiple correlations showed statistically significant correlation of age, diastolic pressure and larger zone of myocardial infarction with an increase of NT pro-BNP concentration. The activity of CK on the day after admission was higher than on admission (p=0.02) and myocard-binding CK (CK-MB) the next day after admission was higher than on admission (p=0.016). A statistically significant increase was found on the next day for NT pro-BNP in comparison with the value on admission (p=0.0049), but the level of activity of CK was markedly decreased on the eighth hospital day. CONCLUSION The significant increase of the concentration of NT pro-BNP during myocardial infarction is an important predictor of early heart failure, therefore, in case of a significant increase of NT pro-BNP in the early phase of the infraction a therapy that could prevent clinically relevant heart failure should be administered .