Evaluation of the Efficiency of N-terminal Pro-B-type Natriuretic Peptide for Diagnosis of Acute Myocardial Infarction

Abstract

Background: Cardiac diseases are one of the major causes of death worldwide with increasing incidence rate per year, particularly in developing countries such as Sudan owing to urbanization and changing lifestyle. Myocardial infarction is a consequence of the imbalance between the heart blood supply and the required heart cell; this disorder leads to necrosis of myocardium and may cause death. It could be diagnosed by at least two of the following criteria: chest pain, electrocardiography (ECG) elevation, and levels on cardiac biomarkers. This study aimed to evaluate the efficiency of N-terminal pro- B-type natriuretic peptide (NTproBNP) for the diagnosis of acute myocardial infarction (AMI).

Methods: This analytical case–control hospital-based study was conducted on total of 70 individuals, of which 40 participants were suspected of or diagnosed with AMI,while30 healthy subjects were included as a control group. Three ml of venous blood were collected in lithium heparin  containers. Troponin I (TnI) as a cardiac biomarker was measured by TOSOH AIA-360,while theNTproBNP level was detected using I-Chroma II. Personal and clinical data were collected directly from each participant usinga predesigned questionnaire.

Results: A significant increase in the TnI level (mean: 13.13 ± 18.9ng/ml) and NTproBNP (mean: 5756.5 ± 8378.2pg/mL) in AMI patients were detected when compared with control mean (0.02 ± 0.00ng/ml and 57.8 ± 42.32pg/mL, respectively).

Conclusions: NTproBNP gave a high sensitivity (87.5%), specificity (100%), positive predictive value (100%), and negative predictive value (85.7%) in the diagnosis of AMI when compared with another cardiac biomarker such as TnI.

Keywords: acute myocardial infarction, NTproBNP, troponin I, Medani Heart Center, Sudan