The role of admission platelet count and B-type natriuretic peptide in predicting in hospital morbidity in ST-elevation myocardial infarction patients

Abstract

Context: Platelets play a major role in the pathophysiology of acute myocardial infarction. Aim: This study aims to evaluate the potential correlation between admission platelet count (PLT) and B-type natriuretic peptide (BNP) with the development of severe heart failure during the first 24 h post primary PCI (post-PPCI) in patients admitted with ST-elevation myocardial infarction (STEMI). Settings and Design: This was cross-sectional follow-up study. Methods: One hundred and forty-six patients admitted with STEMI. At the time of admission, blood samples were drawn to measure PLT and BNP level. Twenty-four h after reperfusion, patients were assessed using Killip score, and a transthoracic echo was done to determine ejection fraction (EF) using modified Simpson's rule. Statistical Analysis: Comparison between parametric quantitative independent groups done by t-test. The area under the receiver operating characteristic (ROC) area under the curve was calculated to determine the sensitivity and specificity of PLT in diagnosing severe heart failure (Killip III and IV) Confounding bias has been addressed through a multivariate logistic regression model. Results: we found a significant negative correlation between admission PLT and left ventricular EF measured 24 h post-PPCI and a positive correlation between PLT and both BNP and CKMB level measured at admission (P = 0.001, 0.004and P = 0.007, respectively). ROC curve analysis showed a platelet cut-off value of 290 × 103 to diagnose severe heart failure (Killip's grades III and IV) (sensitivity of 70% and specificity of 83.1%.). Conclusion: BNP and PLT are easy, inexpensive blood tests that can be used as predictors of heart failure post-STEMI.

Keywords

• brain natriuretic peptide
• platelet count
• st-elevation acute myocardial infarction