High BNP level as risk factor for acute kidney injury and predictor of all-cause mortality in STEMI patients

• Published in: Herz Vol. 39; no. 4; pp. 507 - 514
• Main Authors: Akgul, O., Uyarel, H., Pusuroglu, H., Isiksacan, N., Turen, S., Erturk, M., Surgit, O., Celik, O., Oner, E., Birant, A., Akturk, I.F., Uslu, N.
• Format: Journal Article
• Language: English
• Published: Munich Urban & Vogel 01.06.2014; Springer Nature B.V
• Subjects: Acute Kidney Injury - blood; Acute Kidney Injury - mortality; Age Distribution; Biomarkers - blood; Cardiology; Comorbidity; e-Herz: Original article; Female; Humans; Incidence; Internal Medicine; Male; Medicine; Medicine & Public Health; Middle Aged; Myocardial Infarction - blood; Myocardial Infarction - mortality; Myocardial Infarction - surgery; Natriuretic Peptide, Brain - blood; Percutaneous Coronary Intervention - mortality; Prognosis; Prospective Studies; Reproducibility of Results; Risk Factors; Sensitivity and Specificity; Sex Distribution; Survival Rate; Turkey - epidemiology; Turkey; ST-Strecken-Hebungs-Infarkt; BNP; Primary angioplasty; Mortality; Acute kidney injury; ST-segment elevation myocardial infarction; Akutes Nierenversagen; Primäre Angioplastie; Mortalität
• ISSN: 0340-9937; 1615-6692
• DOI: 10.1007/s00059-013-3853-8

Objectives The aim of this study was to evaluate the predictive value of brain natriuretic peptide (BNP) in the development of acute kidney injury (AKI) and 6-month all-cause mortality after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) in a modest-risk population. Background The prognostic value of BNP has been well documented in patients with acute coronary syndrome. However, its value in development of AKI and 6-month all-cause mortality in patients with STEMI undergoing primary PCI remains unclear. Methods We prospectively enrolled 424 consecutive STEMI patients (mean age 53.6 ± 12.1 years) undergoing primary PCI. The population was divided into two groups: a high (n = 110) and a low (n = 314) admission BNP group according to the cut-off value (> 88.7 pg/ml) determined by ROC analysis to have the best predictive accuracy for 6-month all-cause mortality. The clinical characteristics as well as the in-hospital and 6-month outcomes of patients undergoing primary PCI were analyzed. Results Cox multivariate analysis showed that a high-admission BNP value (> 88.7 pg/ml) was an independent predictor of AKI development (odds ratio, 1.002; 95 % confidence interval, 1.000–1.003; p = 0.02) and 6-month all-cause mortality (odds ratio, 1.003; 95 % confidence interval; 1.001–1.004; p = 0.004). Conclusion These results suggest that a high-admission BNP level is associated with an increased risk of AKI development and 6-month all-cause mortality in patients with STEMI undergoing primary PCI.