Prognostic Value Of Plasma Concentration About B-type Natriuretic Peptide And Neutrophil Percent With Acute Coronary Syndromes

Objective: To investigate the relationship between prognostic value of plasma concentration about B-type natriuretic peptide(BNP) and neutrophil percent among patients with Acute Coronary Syndromes(ACS), meanwhile assess risk stratification, prognos short term mortality in patients with ACS.Methods: Application of enzyme-linked immunosorbent assay (ELISA) was used to determine the clinical diagnosis of acute coronary syndrome patients with the diagnosis of 73 cases (49 males, 24 females) in serum BNP level, the percentage of blood neutrophils.The patients were grouped by electrocardiogram (ECG) and myocardium enzyme,namely ST-segment elevation myocardial infarction (STEMI ,30 cases), none ST-segment elevation myocardial infarction (NSTEMI, 16 cases), unstable angina (UA, 27 cases).They were final diagnosed by coronary artery angiography. 21 chest pain cases (12 male, 9 females) were selected for the determination of these two indicators as the control group,but their examination of coronary angiography were normal.Meanwhile, the concentration of cardiac troponin I (CTnI),low density lipoprotein C (LDL-C),high density lipoprotein C (HDL-C),acidum uricum were measured for all selected objects. Otherwise,left ventricle ejection fraction (LVEF),left ventricle diastolic diameter (LVDd) were measured by echocardiaography.The totality were followed up clinical events (death,new or recurrent angina,new or recurrent myocardial infarction,new or worsening congestive heart failure and cardiovascular symptoms re-admission) happened at the tenth days,1,3 and 6 months.Results: 1. BNP concentration of the study was as follows : STEMI group 153.62±49.01 pg/ml;the NSTEM group 145.374±43.23 pg/ml;the UA group 72.17±42.85 pg/ml; the control group 38.95±31.81 pg/ml. BNP concentration of acute coronary syndrome was significantly higher than that of the normal control group. There was remarkable statistics diference about concentration of BNP between the acute myocardial infarction group (STEMI and NSTEMI) and the UA group (P＜0.05). Neutrophil percent results were as follows: the STEMI group 72.5 %±9.0 %; the NSTEM group 76.2 %±13.2 %; the UA group 65.3 %±11.1%; the control group 58.6 %±7.1%, myocardial infarction group and NSTEMI group were higher than those of the percentage of neutrophils in blood with unstable angina and the normal control group, the difference was statistically significant (P＜0.05). 2. The ACS plasma concentration of BNP were positively correlated with CTnI,neutrophil percent and LVDd (r=0.535; r=0.628; r=0.675, P=0.001); negatively correlated with LVEF (r=-0.815, P=0.001); neutrophil percent were positively correlated with CTnI,plasma concentration of BNP and LVDd (r=0.424; r=0.628; r=0.662, P=0.001), negatively correlated with LVEF (r=-0.722, P=0.001). 3. Plasma concentration of BNP and neutrophil percent were correlated with incidence of clinical events in patients with ACS. Compared with neutrophil percent, plasma concentration of BNP may be a better clinical indicator to predict the prognosis to patients with acute coronary syndromes.Conclusionns: 1. Plasma concentration about BNP and blood neutrophil percent were remarkable diference among patients with ACS.The extent of myocardial infarction and inflammatory reaction were evaluated by plasma concentration of BNP and blood neutrophil percent. 2. BNP concentration and blood neutrophil percent were not affected by gender and age. 3. Prognosis of short term was evaluated by measuring blood neutrophil percent and plasma concentration of BNP.