Predictive value of the serum level of N-terminal pro-brain natriuretic peptide and high-sensitivity C-reactive protein in left ventricular remodeling after acute myocardial infarction

This study was designed to measure the correlation between left ventricular (LV) remodeling 3 months after successful reperfusion therapy, and the levels of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) and high-sensitivity C-reactive protein (hs-CRP) at 3 days after acute myocardial infarction (AMI), and to determine the predictive levels of NT-proBNP and hs-CRP for LV remodeling. A total of 106 patients with first AMI were included in this study. Each patient was examined by echocardiography (ECG) on the third day and third month after AM], and LV remodeling was determined by the difference in the LEV end-diastolic volume (LVEDV) between the third day and the third month. Serum NT-proBNP and hs-CRP level were measured 3 days after AMI. Then the correlation between the 3-months change in LVEDV and the levels of serum NT-proBNP or hs-CRP was determined. In addition, sensitivity and specificity were calculated with a receiver operating characteristic (ROC) curve to identify correspondence with LV remodeling (defined as the change rate of LVEDV >20%). Our results showed that the correlation coefficients with the change of LVEDV were 0.706 for serum NT-pro BNP (P<0.001) and 0.596 for hs-CRP (P<0.05). With a cutoff value of 0.2, the area under the ROC curve (AUC) was 0.894 for NT-proBNP and 0.825 for hs-CRP. Although the AUC did not statistically differ between NT-proBNP and hs-CRP, NT-proBNP is more effective than serum hs-CRP as a marker to predict LV remodeling.