Key result
Right atrial infarction shows no link to 12-month MACE, while elevated NT-proANP predicts death.
Why the study?
Atrial ischemia likely impairs ANP production, and the study aimed to assess the association between atrial infarction and the prognostic value of NT-proANP in patients with MI treated with primary PCI.
Does right atrial infarction affect the incidence of major adverse cardiovascular events in STEMI patients treated with primary PCI?
Cohort (n=100)
No
Does right atrial infarction affect the incidence of major adverse cardiovascular events in STEMI patients treated with primary PCI?
Right atrial infarction does not impact 1-year prognosis in STEMI patients treated with primary PCI, but NT-proANP levels serve as strong independent predictors of mortality.
Right atrial infarction should not alter STEMI risk models post-PCI; leaves open NT-proANP validation as an independent mortality predictor.
Atrial natriuretic peptide (ANP) is secreted in response to the stretching of the atrial wall. Atrial ischemia most likely impairs the ability of atrial myocytes to produce ANP. Atrial infarction (AI) is rarely diagnosed but not infrequently associated with myocardial infarction (MI). The aim of the study was to assess the association between AI and the prognostic value of N-terminal proANP (NT-proANP) in patients with MI treated with primary percutaneous coronary intervention (PCI). We evaluated data of 100 consecutive patients. Plasma levels of NT-proANP were measured by the ELISA method. ECG recordings were interpreted to diagnose AI according to Liu’s criteria. All patients were followed-up prospectively for 12 months for the manifestation of major adverse cardiovascular events (MACE), defined as unplanned coronary revascularization, stroke, reinfarction or all-cause death. AI was diagnosed in 36 patients. 14% of patients developed MACE. AI did not affect the incidence of MACE or any of its components, nor the patients’ prognosis. NT-proANP revealed to be a strong predictor of death but was not associated with other adverse events. Conclusions: AI in patients with MI treated with primary PCI is not connected with their prognosis nor affects the usefulness of NT-proANP in predicting death during the 12-month follow-up.
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Kacprzak et al. (2021) conducted a cohort in ST-segment elevation myocardial infarction (STEMI) (n=100). Right atrial infarction (RAI) vs. No right atrial infarction was evaluated on Major adverse cardiovascular events (unplanned coronary revascularization, stroke, reinfarction, or all-cause death) at 12 months (p=0.9081). Right atrial infarction did not affect the 12-month incidence of major adverse cardiovascular events (p=0.9081), whereas elevated NT-proANP levels were strong predictors of all-cause death.
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