Norepinephrine Level as a Predictor of Mortality After First Myocardial Infarction

Journal of Clinical and Basic Cardiology 2005; 8 (1-4): 55-58

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Keywords: Herztod,  Kardiologie,  Myokardinfarkt,  Norepinephrin,  cardiac death,  cardiology,  myocardial infarction

The objective of this study was to determine whether the magnitude of adrenergic activation, as measured by plasma norepinephrine concentration (PNE) in the acute phase of myocardial infarction, may be useful as an independent predictor of long-term morbidity and mortality following acute myocardial infarction (AMI). Plasma norepinephrine was obtained within 3 days of admission to the cardiac intensive care unit in 146 randomly selected patients presenting with their first AMI. We analysed the relationship between the initial PNE and the clinical outcomes of death, reinfarction, and congestive heart failure during the subsequent 18 months. Patients with initial PNE over 565 pg/ml (n = 54) were found to have a significantly higher likelihood of cardiac death within the following 18 months (RR = 4.22; p = 0.04), as compared with patients with a lower PNE (n = 98). Even adjustment for variables significant on the univariate level, the difference in mortality remained significant (RR = 4.67; p = 0.03). No correlation was found between PNE and subsequent incidence of reinfarction and congestive heart failure in these patients (RR = 0.087; p = 0.80 and RR = 1.00; p = 0.09, respectively). Our observations support the hypothesis that PNE obtained early in the course of myocardial infarction can be a useful independent prognostic tool for post-AMI mortality.