Evaluation Of D-dimer, NT-proBNP And LVEF On The Severity Of Coronary Artery Lesion And The Short Term Prognosis For ST Segment Elevation Myocardial Infarction

Objective:To investigate the evaluation of D-dimer, NT-pro BNP and LVEF on the severity of coronary artery lesion and the short term prognosis for acute ST segment elevation myocardial infarctionMethods:We enrolled 191 STEMI patients admitted in the First Hospital of Jilin University from January 2014 to April 2014 in this retrospective study.All were within 12 hours of onset and were treated with EPCI. We registered age, sex, the laboratory parameters and screenage assist examination. We investigated the correlation between Gensini score and D-dimer, LVEF and NT-pro BNP. The patients were divided into two groups: hospital adverse events negative(Group A)and hospital adverse events positive(Group B). Then we analysed the evaluation of D-dimer combined with NT-pro BNP and LVEF on the short term prognosis for acute ST segment elevation myocardial infarction. The analysis were performed with SPSS18.0 software, and the difference was statistically significant with P<0.05.Results:1. Gensini score had weakly correlation with D-dimer and LVEF, with the coefficient respectively was 0.297,-0.168 and P<0.05, but there was no correlation with NT-pro BNP.2. There were no statistical differences in gender, hypertension, diabetes mellitus, smoking,family history of CHD, stroke, hepatic and renal function, TG, TC, HDL-C and FBG between two groups(P>0.05). The level of LDL-C and Age in group B were significantly higher than that in group A(P<0.05).3. There were no statistical differences in left ventricular end diastolic diameter, Gensini score, multi-vessel lesions, multi-stents placement, thrombus aspiration and Tirofiban between two groups(P > 0.05).The level of DD, NT-pro BNP, LVEF and the peak of c Tn I in group B were significantly higher than that in group A(P<0.05).4. By multivariate logistic regression, analysis suggest that LDL-C(OR=2.084, P = 0.007), NT pro BNP(OR=1.001, P = 0.043) and LVEF(OR=0.925, P=0.006) were the independent predictive factor5. The area under the curve of LVEF and NT-pro BNP respectively was 0.747 and 0.699, with the cutoff value respectively was.51% and 231.5ng/ml. The risk of cardiovascular events during hospitalization was greater when NT-pro BNP was greater than 231.5ng/ml and the LVEF was less than 51%. The more significant was LVEF.Conclusion:1. Gensini score had weakly correlation with D-dimer and LVEF, but did not with NT-pro BNP2. LDL-C,NT pro BNP and LVEF were the independent predictive factor of hospital adverse events in STEMI.3. The risk of cardiovascular events during hospitalization was greater when NT-pro BNP was greater than 231.5ng/ml and the LVEF was less than 51%. The more significant was LVEF.