The Relationship Study Between BNP Levels And CK-MB, CTNI Concentrations, The Degree Of Coronary Artery Disease, Heart Function In Patients With ST-segment Elevation Acute Myocardial Infarction

Objective: The aim of the study is to analysis the relationship between BNP levels and CK-MB,cTNI concentrations, the degree of coronary artery disease and heart function in patients with ST-segment elevation acute myocardial infarction by measuring the myocardial enzyme levels, performing coronary angiography and heart function examinations. And learn deeply the evaluation of the BNP testing in patients with coronary artery disease.Methods: From December 2007 to November 2008,we selected 105 patients with acute myocardial infarction,and 86 of them( 58 males and 28 females, average age was 62.47±7.78 years old ) who got recanalization therapies by intravenous thrombolysis within 6 hours after myocardial infarction enrolled our study. All patients admitted to hospital were examined the BNP levels at the points of 12h,16h,20h,24h after myocardial infarction and the CK-MB,cTNI peak concentrations within 24h, examined the heart function by ultrasonic cardiography within one week, performed cardioangiography examination within 7 to 10 days after myocardial infarction. And they were divided into A group (BNP <100pg/ml), B group (BNP100-500 pg / ml), C group (BNP> 500 pg / ml) according to the BNP peak level. So we can evaluate the relationship between BNP levels and CK-MB ,cTNI concentrations, the degree of coronary artery disease,heart function by having an correlation-ship analysis.We used SPSS11.5 statistics software to analysis all of the data. Differences among group means were assessed with the analysis of variance. Theχ2 analysis or the fisher exact test was used to test differences of proportions. The correlation between two parameters was analyzed by Spearman correlation analysis. Statistical significance was indicated by P value<0.05.Result: There were no statistical differences among A, B, C groups in gender, age, smoking, hypertension, diabetes, hyperlipidemia, and drug treatments. Among A,B,C groups , the higher the BNP levels are, the higher the CK-MB levels are (79.76±10.28U/L vs 92.43±9.27U/L vs 108.80±15.46 U/L),P <0.05, so are the cTNI peak levels (5.67±0.67ng/L vs 6.51±0.65ng/L vs 7.64±0.66ng/L),P<0.05.Spearman correlation analysis showed that there is a significantly correlation between BNP peak levels and CK-MB,cTNI peak concentrations, and were significantly positively correlated , correlation coefficients are r = 0.69, P <0.05, r = 0.74, P <0.05,respectively, which all had a statistical significance. On the other hand, the higher the BNP levels are, the lower the LVEFs are. (55.06±4.51% vs 46.25±4.80% vs 43.04±5.29%),P <0.05,Spearman correlation analysis also showed that there is a significantly correlation between BNP peak levels and LVEFs levels, but were significantly negatively correlated , correlation coefficients is r = -0.64, P <0.01, which had a statistical significance. The results of CAG and LVG showed that the rate of single-vessel lesion in the group A was higher than that in the group B and C(78% vs 46% vs 28%),P<0.05,on the other hand, the rate of multi-vessel lesion in the group C was higher than that in the group B and A(72% vs 53 % vs 18%),P<0.05. The rate of coronary lesion type A in the group A was higher than that in group B, C(57% vs 35% vs 16%),P<0.05.the rate of coronary lesion type C in the group C was higher than that in group B, A(60% vs 46% vs 24%)P<0.05。Leaman coronary score show that scores in C group are higher than that in B,A groups (102.5 vs 127 vs 150),P<0.05. there is a significantly correlation between BNP peak levels and leaman coronary scores, and were significantly positively correlated , correlation coefficients is r = 0.47, P <0.05. There were no significant differences about the incidence of collateral circulation and the grade of thrombolusis in myocardial infarction(TIMI)blood flow. There was increased trend of left ventricular end diastolic pressure(LVEDP) (10.06±1.62mmHg vs 11.32±2.03mmHg vs 16.72±2.70mmHg),P<0.05. We also had a correlation and regression analysis to the patients with anterior wall myocardial infarction, and Spearman correlation analysis showed that there are more significantly correlation between BNP peak levels and CK-MB, cTNI, LVEF, LVEDP levels, correlation coefficients were 0.71, 0.74,-0.69,0.71 respectively.And we got the linear regression equation between BNP peak levels and LVEFs ,cTNI levels Y=0.5466-0.00015X , P <0.05 ; Y=5.6314+0.0023X , P <0.05,which all had statistical differences。Conclusion: 1. The higher the BNP peak levels are , the higher the CK-MB cTNI levels are and the lower the LVEFs are in acute myocardial infarction patients .The correlation-ship between BNP peak levels and CK-MB , cTNI peak concentrations are positive ,but is negative between BNP levels and LVEF.2. There is a significantly positive correlation between BNP levels and the degree of coronary artery disease, There were more severe degree of coronary artery disease and multi-vessel lesion in the higher BNP level patients.