Utilizing natriuretic peptides for predicting heart failure risk following myocardial infarction

Background: In Mongolia, ischemic heart disease, specifically acute myocardial infarction (AMI), is a significant etiology of chronic heart failure (HF). Therefore, early recognition of the risk of HF following AMI is critically important for improving patient management. This study aimed to assess the N-terminal pro-B-type natriuretic peptide (NT-proBNP) as an early detection and prognosis of asymptomatic left ventricular (LV) dysfunction following AMI. Methods: Patients diagnosed with AMI and in the absence of symptoms or signs of HF were prospectively included. Clinical and echocardiographic data were collected at baseline, and NT-proBNP levels were measured at admission and discharge. Patients were divided into four distinct groups based on NT-proBNP level quartiles. The study endpoint was de-novo HF at 6 months after AMI. Results: = 97) men were included. Higher NT-proBNP levels were associated with elevated GRACE score and diabetes, both at admission and predischarge. Additionally, higher NT-proBNP levels at admission were associated with delayed hospital presentation, whereas higher NT-proBNP levels at predischarge were associated with reduced LV global longitudinal strain. Furthermore, NT-proBNP level at predischarge was significantly associated with the development of HF 6 months after AMI, with a threshold value of 1410 pg/ml. Conclusion: Incorporation of NT-proBNP measurement before discharge in AMI patients could enhance risk stratification, thereby supporting its integration into routine clinical evaluation for more efficient patient management.