Email this article Significance of the N-terminal Fragment of Brain Natriuretic Peptides in Predicting Ventricular Arrhythmias in Young and Middle-Aged Patients with Diabetes and Myocardial Infarction
- Authors: Wang Z.1, Makeeva T.I.1, Zbyshevskaya E.V.1, Butaev T.D.1, Saiganov S.A.1
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Affiliations:
- North-Western State Medical University named after I.I. Mechnikov
- Issue: Vol 2, No 4 (2022)
- Pages: 17-28
- Section: Original Research
- URL: https://journals.rcsi.science/cardar/article/view/132569
- DOI: https://doi.org/10.17816/cardar115243
- ID: 132569
Cite item
Abstract
Fatal ventricular arrhythmias in patients with diabetes mellitus (DM) in the acute stage of myocardial infarction (MI) and postinfarction period often cause adverse outcomes. Therefore, the search for new reliable biomarkers in predicting ventricular arrhythmias in the long term is necessary.
AIM: This study aimed to evaluate the value of N-terminal-pro hormone BNP (NT-proBNP) in predicting ventricular arrhythmias in young and middle-aged patients with MI and DM-associated ST-segment elevation.
MATERIALS AND METHODS: Seventy-six patients (59 men and 17 women) with DM and MI with ST-segment elevation (aged 36–59 years; mean 53 ± 5 years) were examined. Anterior MI was diagnosed in 35 patients, and non-anterior MI was detected in 41 patients. The DM duration was up to 1 year in 16 patients, 1–5 years in 24, and 5–12 years in 36. Patients were examined on day 1 after percutaneous coronary intervention (PCI) with implantation of 1–3 stents in the coronary arteries (CA) and again after 12 months. Holter monitoring, echocardiography, and blood tests for NT-proBNP were performed.
RESULTS: After PCI, ventricular extrasystole (VES) of grades III–V according to Lown and Wolf was detected in 21 of 37 (56.7%) patients with DM. The left ventricular ejection fraction (LVEF) was 42% (27%–45%), and the NT-proBNP level was 1127 (790–2530) at a rate of up to 125 pg/mL. After 12 months, VES was noted in 9 of 37 (24.3%) patients. The LVEF was 33% (28%–35%), and the NT-proBNP level was 938 (497–1294) pg/mL. A positive correlation was found between the blood serum level of NT-proBNP on day 1 after PCI and the number of grade III–V VES 12 months later. At an NT-proBNP level of > 898 pg/mL on day 1 after PCI, the sensitivity of this biomarker in predicting high-grade VES 12 months after MI in patients with DM was 100%.
CONCLUSIONS: The NT-proBNP level after PCI in patients with DM and MI is a reliable predictor of ventricular arrhythmias over the next 12 months.
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##article.viewOnOriginalSite##About the authors
Zheming Wang
North-Western State Medical University named after I.I. Mechnikov
Email: polarbear8822@mail.ru
ORCID iD: 0000-0001-8076-9829
SPIN-code: 6791-9997
Scopus Author ID: 1175863
graduate student
Russian Federation, Saint PetersburgTatyana I. Makeeva
North-Western State Medical University named after I.I. Mechnikov
Author for correspondence.
Email: tatianamakeeva@gmail.com
ORCID iD: 0000-0003-3819-486X
SPIN-code: 4915-3109
MD, PhD, professor
Russian Federation, Saint PetersburgElizaveta V. Zbyshevskaya
North-Western State Medical University named after I.I. Mechnikov
Email: zbyshev@hotmail.com
ORCID iD: 0000-0002-2565-3548
SPIN-code: 7761-0942
PhD, associate professor
Russian Federation, Saint PetersburgTamerlan Dz. Butaev
North-Western State Medical University named after I.I. Mechnikov
Email: tamerlan1950@yandex.ru
ORCID iD: 0000-0003-0113-6789
PhD, associate professor
Russian Federation, Saint PetersburgSergey A. Saiganov
North-Western State Medical University named after I.I. Mechnikov
Email: sergey.sayganov@szgmu.ru
ORCID iD: 0000-0001-8325-1937
SPIN-code: 2174-6400
Head of the Department
Russian Federation, Saint PetersburgReferences
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