High brain natriuretic pepdite level as an independent risk factor for acute kidney injury and predictor of increased six-month all-cause mortality in patients undergoing primary angioplasty for STEMI

Abstract

Objectives: The aim of the present study was to evaluate the predictive effect of brain natriuretic pepdite (BNP) for prevalance of acute kidney injury (AKI) development and six-month all-cause mortality after primary percutan coronary intervention (PCI) for ST elevation myocardial infarction (STEMI) in a modest 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 six-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 study population was divided into tertiles based on admission BNP values. The high BNP group (n=141) was defined as a value in the third tertile (>56.6 pg/ mL), and the low BNP group (n=283) included those patients with a value in the lower two tertiles (≤ 56.6 pg/ mL). Clinical characteristics and in-hospital and six-month outcomes of primary PCI were analyzed. Results: In Cox multivariate analysis; a high admission BNP value (>56.6 pg/ mL) was found to be a powerful independent predictor of AKI devolopment (odds ratio: 1.002, 95% confidence interval: 1.000- 1.003, p= 0.02) and six-month all-cause mortality (odds ratio: 9.1, 95% confidence interval: 1.85-43.9, p=0.006). Conclusions: These results suggest that a high admission BNP level was associated with increased prevalance of AKI devolopment and six-month all-cause mortality in patients with STEMI undergoing primary PCI.