Serum N-Terminal pro brain natriuretic peptide as predictor of left ventricular remodeling in diabetic subjects with acute coronary syndrome

Atherothrombosis can no longer be considered a disease of the developed world, because myocardial infarction and stroke are increasingly prevalent worldwide, Insulin resistance and diabetes rank among the major cardiovascular risk factors, The level of BNP may reflect the size or severity of the ischemic insult, even when myocardial necrosis has not accurred.

To determine the level of serum NT-PRO brain natriuretic peptide which marked an increased incidence of cardiovascular events in unselected community-based individuals with diabetes mellitus and Acute coronary syndrome admitted to cardiology care unite within 24 hour.

Clinical, echocardiographic, and laboratory characteristics, Including N-Terminal pro brain natriuretic peptide (NT-PRO BNP), troponin I (TnI), C-reactive protein (CRP), and Glucose were measured within 24 hours of hospitalization for 70 patients, they divided into two groups according to Blood glucose level (diabetic & non diabetic). Twenty healthy subjects were considered as control group. The present study was conducted at the Department of Bio Chemistry, College of Medicine, University of Baghdad and Baghdad Teaching Hospital during the period from April 2016 to April 2017.

The patients with Acute coronary syndrome(A.C.S) were found to have significantly higher mean(± SEM) value of serum NT-PRO BNP as compared with mean (± SEM) value of serum control group(p<0.001).

The mean(± SEM) values of serum NT-PROBNP concentrations, hs-troponine I, hs-CRP, left atrium diameter and E/e were non significantly higher in diabetic group than non diabetic group, while mean(± SEM)values of isovolumic relaxation time and deceleration time were found non significantly higher in non diabetic group than in diabetic group. However, the mean(± SEM)value of ejection fraction was significantly higher in non diabetic group than in diabetic group, (P-value=0.0261).

A single measurement of NT-PROBNP on admission can predict earlly and degree of left ventricular remodeling in diabetic patients with Acute coronary syndrome.