Analysis of the Relationship between Circulating NT-proBNP and Myocardial Injury, Inflammatory Response and Coronary Collateral Circulation in Acute Myocardial Infarction before Clopidogrel Treatment

Abstract

Prior to the initiation of clopidogrel treatment, this study focuses on exploring the relationship between N-terminal prohormone of brain natriuretic peptide and the severity of myocardial injury, inflammatory response markers, as well as the development of coronary collateral circulation in individuals diagnosed with acute myocardial infarction. The experimental group (n=70) included individuals with acute myocardial infarction receiving clopidogrel treatment from October 2019 to February 2022. As a comparison, during the same period 70 healthy individuals were included as the control group. The comparison included markers of myocardial injury (cardiac troponin I, creatine kinase-myocardial band, myoglobin) and inflammatory markers (tumor necrosis factor alpha, C-reactive protein, interleukin-6) along with N-terminal prohormone of brain natriuretic peptide levels. N-terminal prohormone of brain natriuretic peptide levels were also compared in different grades of cardiac function and coronary collateral circulation. This research investigated the connection between N-terminal prohormone of brain natriuretic peptide, myocardial injury, inflammatory response, and coronary collateral circulation in acute myocardial infarction patients. The experimental group exhibited remarkably increased levels of cardiac troponin I, creatine kinase-myocardial band, and myoglobin (p<0.05), along with elevated levels of interleukin-6, C-reactive protein, tumor necrosis factor alpha, and N-terminal prohormone of brain natriuretic peptide in comparison to the control group. Notably higher N-terminal prohormone of brain natriuretic peptide levels were found in cardiac function class IV patients compared to class III and class II (p<0.05). Higher N-terminal prohormone of brain natriuretic peptide levels were observed in coronary collateral circulation grade 3 patients as opposed to grade 2 and grade 1 (p<0.05). Serum N-terminal prohormone of brain natriuretic peptide showed positive correlation with cardiac troponin I, creatine kinase-MB, myoglobin, interleukin-6, C-reactive protein, tumor necrosis factor alpha, and cardiac function classification (p<0.05), and negative correlation with coronary collateral circulation (p<0.05). Prior to clopidogrel treatment, patients with acute myocardial infarction exhibit a notable correlation between circulating N-terminal prohormone of brain natriuretic peptide and the degree of myocardial injury, inflammatory response markers, and coronary collateral circulation.