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Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial.

Publication ,  Journal Article
van Diepen, S; Roe, MT; Lopes, RD; Stebbins, A; James, S; Newby, LK; Moliterno, DJ; Neumann, F-J; Ezekowitz, JA; Mahaffey, KW; Hochman, JS ...
Published in: J Thromb Thrombolysis
July 2012

Coronary plaque rupture is associated with a systemic inflammatory response. The relationship between baseline N-terminal pro B-type natriuretic peptide (NT-proBNP), a prognostic marker in patients with acute coronary syndromes, and systemic inflammatory mediators in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) is not well described. Of 5,745 STEMI patients treated with primary PCI in the APEX-AMI trial, we evaluated the relationship between baseline NT-proBNP levels and baseline levels of inflammatory markers and markers of myonecrosis in a subset of 772 who were enrolled in a biomarker substudy. Spearman correlations (r (s)) were calculated between baseline NT-proBNP levels and a panel of ten systemic inflammatory biomarkers. Interleukin (IL)-6, a pro-inflammatory cytokine, was significantly positively correlated with NT-proBNP (r (s) = 0.317, P < 0.001). In a sensitivity analysis excluding all heart failure patients, the correlation between baseline IL-6 and NT-proBNP remained significant (n = 651, r (s) = 0.296, P < 0.001). A positive association was also observed with high sensitivity C-reactive protein (r (s) = 0.377, P < 0.001) and there was a weak negative correlation with the anti-inflammatory cytokine IL-10 (r (s) = -0.109, P = 0.003). No other significant correlations were observed among the other testes inflammatory cytokines and chemokines. In STEMI patients undergoing primary PCI, the pro-inflammatory cytokine IL-6 was modestly correlated with baseline NT-proBNP levels. This relationship remained significant in patients without heart failure. This finding is consistent with pre-clinical and clinical research suggesting that systemic inflammation may influence NT-proBNP expression independently of myocardial stretch.

Duke Scholars

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

July 2012

Volume

34

Issue

1

Start / End Page

106 / 113

Location

Netherlands

Related Subject Headings

  • Peptide Fragments
  • Necrosis
  • Natriuretic Peptide, Brain
  • Myocardium
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Interleukin-6
  • Interleukin-10
  • Inflammation
 

Citation

APA
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ICMJE
MLA
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van Diepen, S., Roe, M. T., Lopes, R. D., Stebbins, A., James, S., Newby, L. K., … Granger, C. B. (2012). Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial. J Thromb Thrombolysis, 34(1), 106–113. https://doi.org/10.1007/s11239-012-0691-0
Diepen, Sean van, Matthew T. Roe, Renato D. Lopes, Amanda Stebbins, Stefan James, L Kristin Newby, David J. Moliterno, et al. “Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial.J Thromb Thrombolysis 34, no. 1 (July 2012): 106–13. https://doi.org/10.1007/s11239-012-0691-0.
van Diepen S, Roe MT, Lopes RD, Stebbins A, James S, Newby LK, et al. Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial. J Thromb Thrombolysis. 2012 Jul;34(1):106–13.
van Diepen, Sean, et al. “Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial.J Thromb Thrombolysis, vol. 34, no. 1, July 2012, pp. 106–13. Pubmed, doi:10.1007/s11239-012-0691-0.
van Diepen S, Roe MT, Lopes RD, Stebbins A, James S, Newby LK, Moliterno DJ, Neumann F-J, Ezekowitz JA, Mahaffey KW, Hochman JS, Hamm CW, Armstrong PW, Theroux P, Granger CB. Baseline NT-proBNP and biomarkers of inflammation and necrosis in patients with ST-segment elevation myocardial infarction: insights from the APEX-AMI trial. J Thromb Thrombolysis. 2012 Jul;34(1):106–113.
Journal cover image

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

July 2012

Volume

34

Issue

1

Start / End Page

106 / 113

Location

Netherlands

Related Subject Headings

  • Peptide Fragments
  • Necrosis
  • Natriuretic Peptide, Brain
  • Myocardium
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Interleukin-6
  • Interleukin-10
  • Inflammation