[Evaluation of plasma renin activity in acute myocardial infarction patients treated with primary percutaneous coronary interventions].

Unlabelled: The aim of this study was evaluation of plasma renin activity (PRA) in patients with acute ST-segement elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions (PCI). We observed 40 patients (30 men, 10 woman) aged 29-69 yrs (mean age 53.9 SD 10.9) with first ST-segment elevation myocardial infarction. Patients were treated with primary percutaneous coronary intervention (PCI) with implantation of bare metal stent in the period up to 6 hours after the onset of chest pain. Plasma renin activity was evaluated on 1st, 3rd and 5th day and 1st and 3rd month after STEMI in all patients. Values of PRA were compared between men and women during a 3-month follow-up. Echocardiography examinations with left ventricular parameter measurements (included ventricular ejection fraction) were performed at 3rd day, 1st and 3rd month after STEMI. In all patients Troponin I level was measured in the first day of STEMI. In addition, the level of NTproBNP and hsCRP in plasma were measured in all patients at 1st day, 1st and 3rd month after STEMI. Changes of PRA levels within 3-months follow-up were evaluated in relation to the age, BMI, serum levels of NTproBNP, hsCRP, lipids and left ventricular function.

Results: Median value of the PRA was 1.4 ng/ml/h at 1st day (N:1.46 +/- 0.23 ng/ml/h); 2.3 ng/ml/h at 3rd day; 3.9 ng/ml/h at 5th day; 2.1 ng/ml/h at 1 month, and 2.7 ng/ml/h at 3 months after STEMI. Peak value of PRA was observed between 5th day and 1st month after STEMI. PRA was significantly higher in men than in women at 1st day after STEMI (1.8 vs. 0.8 ng/ml/h; p = 0.002). There were no differences of PRA between men and women during the rest of the followup (3rd day - 3.3 vs. 2.0 ng/ml/h; 5th day 7.3 vs. 3.5 ng/ml/h; 1st month 4.1 vs. 2.1 ng/ml/h, 3rd month 3.5 vs. 2.2 ng/ml/h. There was no significant correlation between PRA and age, BMI, serum levels of NTproBNP, hsCRP, lipids and left ventricular function.

Conclusions: 1. Values of PRA change within early period after STEMI. The peak value was achieved between 5th day and 1st month after STEMI treated with primary PCI. 2. Plasma renin activity was significantly higher in men than in women at 1st day of STEMI treated with primary PCI.