PLASMA BNP LEVEL AS PREDICTOR TOOL OF MYOCARDIAL INFARCTION IN DIABETIC PATIENTS

Early detection of asymptomatic left ventricular systolic dysfunction (LVSD) or diastolic dysfunction (DD) in Type II Diabetes Mellitus patients may prevent complication such as Myocardial infarction. Present study is aimed to study the prediction chances of myocardial infarction in type II Diabetes mellitus patients using co-relation of plasma BNP level with 2-D-ECHO findings. A total of 100 diabetes mellitus type II patients were studied of which 50 DM had evidence of MI and remaining 50 were without any evidence of MI for more than 5 yrs. BNP values were inversely proportional to left ventricular systolic ejection fraction. This correlation was significant (p<0.001). Elevated BNP levels were significantly correlated with presence of Diastolic Dysfunction (p<0.001).In our study the BNP cutoff value of 100pg/ml had a sensitivity of 90%, specificity of 70 %. In patients with only Diabetes, of the 14 patients with elevated BNP levels and normal Ejection Fraction, 10 revealed diastolic dysfunction. Of the remaining 4, further follow-up of two patients showed presence of Coronary Artery Disease, indicates that BNP is good investigation for detecting underlying coronary artery disease in high risk population such as Type II Diabetes Mellitus