Association of NT-Pro BNP within Hospital Outcome of Anterior STEMI at Tertiary Care Hospital, Chattogram, Bangladesh

Background: BNP (Brain natriuretic peptide) is released from cardiac myocytes due to their stretching, volume overload and high filling pressure. All of these actions result in high wall stress which initiates the release of pro-BNP, precursor of BNP. It cleaves first to pro-BNP, then to the biologically active BNP and the inactive amino-terminal fragment, N-terminal pro hormone of BNP, NT-pro BNP. Objective: This study aims to observe the association of NT-pro BNP with anterior STEMI patients. Methods: A cross-sectional comparative study was conducted in the Department of Biochemistry of Chittagong Medical College and with the collaboration of the Department of Cardiology at Chittagong Medical College Hospital by non-probability purposive sampling. 59 patients having STEMI (myocardial infarction) with heart failure and 59 patients having STEMI (myocardial infarction) without heart failure were investigated. Important variables in this study used were age, gender, MI (myocardial infarction), heart failure and serum NT-pro BNP, and ejection fraction. Result: There was a significant mean difference in NT-pro BNP, serum creatinine, BMI and eGFR between MI with heart failure and anterior STEMI without heart failure. A significant negative correlation was observed between NT-pro BNP and ejection fraction in patients with anterior STEMI with heart failure. Significant negative correlation between NT-pro BNP and eGFR in anterior STEMI with heart failure. Among the study population, all the 59 patients of anterior STEMI with HF have increased NT-pro BNP, and 58 patients of anterior STEMI without HF have increased NT-pro BNP. The eGFR, hypertension group, diabetes, and BMI statistically significantly predict the increased NT-pro BNP in STEMI with heart failure. Conclusion: Elevated NT-pro BNP levels in STEMI patients are strongly associated with the development of heart failure. It serves as a key biomarker for early risk assessment and prognosis. High levels indicate greater myocardial stress and worse cardiac outcomes.