PREDICTING SUDDEN CARDIAC DEATH IN PATIENTS WITH LEFT VENTRICULAR DYSFUNCTION IS CRITICALLY DEPENDENT ON BNP LEVELS.
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Keywords
BNP levels, acute myocardial infarction, sudden cardiac death
Abstract
Background: Despite major advancements in diagnosis and treatment techniques, sudden cardiac arrest is still a serious health risk. To maximize the advantages of implantable cardioverter-defibrillator (ICD) therapy, it is essential to identify those who are more likely to have sudden cardiac death (SCD). Prohormone (NT-proBNP) is the precursor of BNP (natriuretic peptide) and its amino terminal fragment. Patients who have higher blood levels of these peptides are at a higher risk of experiencing an unplanned cardiac arrest.
Objective: The purpose of this study was to assess the importance of BNP levels in order to predict death from sudden cardiac arrest in patients with left ventricular dysfunction.
Study design: A cross-sectional study
Place and Duration: This study was conducted in Civil Hospital Dow University Karachi from August 2022 to August 2023.
Methodology: All the participants involved in this research had ST elevation myocardial infarction (STEMI), complicated by left ventricular systolic failure. Adult patients with acute myocardial infarction must meet two of the following three criteria: they must have a new or indeterminate left bundle branch block (LBBB) with ST segment elevation greater than 0.1 mV in limb leads or 0.2 mV in precordial leads, or they must experience the typical chest discomfort behind the breastbone that nitrates can relieve. For five days, a 12-lead ECG was performed every day to guarantee that the chest leads were positioned consistently. Any irregularities found on the ECG were classified according to certain standards.
Results: A total of 80 patients were included in this research, of which 60 were females and 20 were males. The age of the participants ranged from 35 to 80 years. The mean age was 56.8 years. A total of 61 participants underwent primary percutaneous coronary intervention. However, there were 19 patients who got medical therapy. The mean NYHA for survivors was 2.1 after a follow-up clinical examination. A follow-up of 95 days was conducted, out of which 10 (12.5%) of the participants faced life-threatening arrhythmias, 64 (80%) survived, and 6 (7.5%) died because of sudden cardiac arrest.
Conclusion: BNP levels are a significant and independent predictor of sudden death in patients with ischemic cardiomyopathy after an acute myocardial infarction.
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Ghulam Abbas Shaikh
Assistant Professor of Cardiology, Civil Hospital Dow University Karachi Pakistan.
Sarfraz Hussain Sahito
Assistant Professor of Cardiology, National Institute of Cardiovascular Diseases Khairpur Pakistan.
Samir Rehman
Advanced Imaging Fellow, National Institute of Cardiovascular Diseases Karachi Pakistan.
Iram Jehan Balouch
Associate Professor of Cardiology, National Institute of Cardiovascular Diseases Hyderabad Pakistan.
Ahmed Noor
Program Director Post-graduate Training Cardiology, Indus Hospital Karachi Pakistan.
Muhammad Hashim Kalwar
Associate Professor of Cardiology, National Institute of Cardiovascular Diseases Sukkur Pakistan.