Correlative study of in-hospital clinical outcomes with N terminal – pro B type natriuretic peptide and glycated hemoglobin in acute myocardial infarction
Journal Title: MedPulse -International Medical Journal - Year 2016, Vol 3, Issue 4
Abstract
Background and Objectives: Early risk stratification, in cases of acute myocardial infarction(AMI) is essential to treat high risk patients aggressively, to reduce the morbidity and mortality. In this study we assess the short term prognostic value of N terminal pro B type natriuretic peptide (NT pro BNP), Glycated Hemoglobin (HbA1c), measured at admission, in cases of AMI. Methods: A total of 100 patients, presenting to R L Jalappa Narayana Hrudayalaya Heart Center, will be included into the study. Patients were evaluated with history, physical, electrocardiogram, cardiac markers, NT pro BNP, HbA1c and Echocardiogram. These patients were observed over a period of 7 days in hospital. Patients were monitored for adverse outcomes like heart failure, arrhythmias, reinfarction, mitral regurgitation and any other complications. NT pro BNP values ranged widely from <20 pg/ml to 2000 pg/ml, a value of 125pg/ml in age < 75y and >450 pg/ml in age >75 y was considered abnormal. HbA1c level of >6.5% was considered abnormal. Results: There was a significant negative correlation observed between NT pro BNP and Left ventricular ejection fraction at p – 0.0001. Total of 27 cases developed complications like heart failure, reinfarction, mitral regurgitation which was significantly associated with abnormal NT pro BNP values at p – 0.002. Total 6 patients had died although the NT pro BNP values were elevated in all the cases there was no statistically significant association between NT pro BNP values and mortality. HbA1c was not found to be significantly associated with LVEF, adverse out comes and mortality in short term. Conclusion: NT pro BNP is a strong predictor of in hospital adverse cardiac events. HbA1c was not an independent predictor of short-term outcomes.
Authors and Affiliations
B Sunil Abhishek, B N Raghavendra Prasad
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