Abstract 18759: N-Terminal Pro-B-Type Natriuretic Peptide and High-Sensitivity C-Reactive Protein and Infarct Size Measured With Delayed Enhancement Multidetector Computed Tomography

Abstract

Background: There is a paucity of information on the time-dependent relationship of cardiac biomarkers to infarct size and left ventricular (LV) remodeling after myocardial infarction (MI). We sought to investigate the relationship between levels high-sensitivity C-reactive protein (hs-CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) and indices of infarct size and LV volume after acute MI. Methods: A total of 86 patients with ST-elevation MI within 12 hours after the symptom onset underwent delayed enhancement multi-detector computed tomography (DE MDCT) immediately after percutaneous coronary intervention (PCI) to determine infarct size. LV function and remodeling were assessed by echocardiography. Hs-CRP and NT-proBNP were serially measured at admission, 24 hours, and 2 months. DE MDCT and echocardiography were repeated at 2 months after PCI. Results: Levels of both hs-CRP and NT-proBNP at 24 hours showed positive correlation with infarct size at baseline and at 2 months, and negative correlation with LV ejection fraction at baseline and at 2 months. NT-proBNP at 2 months correlated with infarct size (r=0.561, p=0.007), LV ejection fraction (r= - 0.539, p=0.010), and LV end diastolic and systolic volume indices at 2 months (r=0.796, p=0.032 and r=0.831, p=0.021, respectively). NT-proBNP was higher in patients who developed LV remodeling at 2 months: 929 pg/mL vs. 134 pg/mL, p = 0.002. In contrast, hs-CRP at 2 months showed no relationship to infarct size, LV function, or LV volumes at 2 months. Conclusions: Elevated hs-CRP during active myocardial necrosis was associated with infarct size and LV dysfunction, whereas elevated levels of NT-proBNP early and late after the onset of acute MI were both correlated with infarct size, LV dysfunction, and LV remodeling.