Clinical and biochemical parameters in patients with acute heart failure secondary to myocardial infarction

Abstract

Objective: to study the clinical features, dynamics of the NTproBNP level in patients with STEMI, taking into account the risk of hospital mortality scales. Materials and methods: the study included 150 patients with STEMI. All patients were divided into subgroups: according to the GRACE scale (low, medium and high risk) and the degree of acute heart failure (AHF) classification T.Killip II and III-IV. The clinical and laboratory characteristics of patients, including the level of NTproBNP, were studied. Results: the average age of STEMI patients was 61.7±2.96 years. Dyslipidemia, increased level of markers of myocardial necrosis, high concentration of NTproBNP without tendencies to changes in the dynamics of hospital treatment were detected on the first day of STEMI. Patients with STEMI of Killip III-IV had a statistically significant NTproBNP level 2.0 times higher (p<0.05), and at discharge 2.1 times (p<0.05) compared with the group of patients with Killip II. It should be noted that during hospital treatment, the values of NTproBNP did not change statistically significantly regardless of the degree of T.Killip AHF (p>0.05). A high level of NTproBNP was obtained on the first day of the STEMI in all risk groups of hospital mortality on the GRACE scale. A tendency to increase the values of NTproBNP (p<0.05) with an increase in the risk of hospital mortality was revealed. Conclusion: patients with STEMI AHF Killip III-IV have a greater volume of myocardial damage and the level of NTproBNP, determining a high risk of heart failure. NTproBNP values progressively increase with increasing GRACE scale risk and will not change during inpatient treatment.