Diagnostic value of the N-terminal pro-brain natriuretic peptide and stimulating growth factor in patients with acute coronary syndrome

Abstract

Aim. To determine levels of stimulating growth factor (ST2) and its correlation with levels of N-terminal pro-brain natriuretic peptide (Nt-proBNP) in patients with acute coronary syndrome (ACS).Materials and methods. 186 patients with admitting diagnosis of ACS were examined (81 with ST-elevation myocardial infarction (STEMI) and 86 with non ST-segment myocardial infarction (NSTEMI)). For futher investigation we choose 25 patients (mean age 61,67±1,13) with STEMI (group I) and 24 patients (mean age 61,80±1,13) with NSTEMI (group II). In serum of those patients we determined levels of NT-proBNP and ST2 on days 1 and 10 of hospitalisation using a commercial assays (Biomedica, Slovakia and Critical Diagnostics, USA respectively).Results. On the day 1 of hospitalisation patients with STEMI showed higher serum levels of NT-proBNP (779,41±57,86 pg/ml (I)) in comparison with NSTEMI group (588,96±82,47pg/ml (II)) (р>0,05). On the day 10th of hospitalisation mean levels of NT-proBNP were 369,75±55,22 pg/ml (І) and 139,95±19,57 pg/ml (ІІ) respectively (p<0,01). Level of ST2 was significantly increased in the serum of patients with STEMI on the day 1 of hospitalisation as compared with NSTEMI group (111,71±12,41 ng/ml (I) and 77,58±6,5 ng/ml (ІІ), р<0,05) respectively. On day 10th of hospitalisation in serum of patient from group I ST2 levels were 33,43±4,38 ng/ml whereas in participants from group II ST2 levels were 30,20±2,05 ng/ml (р>0,05). We have shown a strong linear correlation between serum levels of ST2 and NT-proBNP in patients with STEMI (I) on first and 10th days of hospitalisations (r=0,43 and r=0,85; p<0,05 respectively). In group II levels of those markers correlates considerably weaker (r=0,35 and r=0,01; p>0,05).Conclusions. Increased level of NT-proBNP corresponds to the size of necrotic area in myocardial infarction, whereas level of ST2 correlates with severity of heart insufficiency symptoms by ACS. Increased levels of both ST2 and NT-proBNP allows to predict disease progression and possible complications