V.Y. Tseluyko, T.A. Lozova. Clinical and prognostic role of B-type natriuretic peptide in patients with right ventricular myocardial infarction on the background of the Q-wave myocardial infarction of the left ventricular posterior wall during long-term monitoring

The aim – to evaluate the diagnostic significance of B-type natriuretic peptide (BNP) to predict development of the postinfarction period complications at 2.7-year follow-up in patients with myocardial infarction (MI) of right ventricle (RV) on the background of the Q-myocardial infarction of the left ventricle (LV) posterior wall (PW).

Material and methods. The study involved 155 patients with MI of the RV due the Q-MI of the PWLV, age 64.11± 0.78 years. BNP levels were determined on the 2nd day of MI. Follow-up was 2.7±0.4 years. Unstable angina (UA), reinfarction, stroke and death were considered as study endpoints.

Results. Study endpoints were achieved by 62 (40 %) patients: UA – 50 (32.2 %), reinfarction – 15 (9.6 %), stroke – 9 (5.8 %) patients, death – 14 (9.0 %). Concentration of BNP in patients with complicated postinfarction period was significantly higher than in patients without complications (679.99±53.66 fmol/L vs. 407.27±41.08 fmol/L, H<0.0003). The dependence between BNP level and frequency of MI and diabetes mellitus (DM) was shown. The level of BNP was found to be an independent risk factor for paroxysmal AF, high degree AV block, acute heart failure (HF) (Killip III) and cardiogenic shock. It was proven that BNP is a predictor of UA development. Conclusion. The determination of BNP in patients with MI of the RV on the background the Q-MI of PWLV may be useful as an additional marker of life-threatening complications in the acute period of MI and as a predictor of unstable angina during long-term follow-up.

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