The Plasma Level of N-terminal Pro B-type Natriuretic Peptide(NT-proBNP) for Severity of Coronary Artery Stenosis and Early Risk Stratification in Patients with Non ST Elevation Acute Coronary Syndrome.
10.4070/kcj.2004.34.2.133
- Author:
Ki Seok KIM
1
;
Hae Sook HAN
;
Kyung Kuk HWANG
;
Tae Jin YOUN
;
Dong Woon KIM
;
Myeong Chan CHO
Author Information
1. Department of internal Medicine, Chungbuk National University, Cheongju, Korea.
- Publication Type:Original Article
- Keywords:
Natriuretic peptide;
Coronary disease;
Angioplasty
- MeSH:
Acute Coronary Syndrome*;
Angina, Unstable;
Angioplasty;
Arteries;
Constriction, Pathologic;
Coronary Artery Disease;
Coronary Disease;
Coronary Stenosis*;
Coronary Vessels*;
Humans;
Natriuretic Peptide, Brain;
Percutaneous Coronary Intervention;
Plasma*;
Sensitivity and Specificity
- From:Korean Circulation Journal
2004;34(2):133-141
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND AND OBJECTIVES: Although elevations of plasma N-terminal pro B-type natriuretic peptide (NT-proBNP) concentration have been shown to be prognostically significant in patients with non-ST elevation acute coronary syndrome (ACS), the relation between the plasma level of NT-proBNP and the severity of coronary disease remains unknown. SUBJECTS AND METHODS: The NT-proBNP concentration was analyzed in 50 patients with non-ST elevation ACS. We compared plasma NT-proBNP levels and treatment method (medical treatment vs. percutaneous coronary intervention [PCI]). RESULTS: In patients with non-ST elevation ACS, NT-proBNP levels were significantly higher in the PCI (n=37) group than in the medical treatment (n=13) group (296.6 vs. 76.3 pg/mL;p<.001). In patients with unstable angina (UA), NT-proBNP levels were significantly higher in the PCI (n=22) group than in the medical treatment (n=12) group (147.6 vs. 64.5 pg/mL;p<.001). Elevated NT-proBNP level predicted PCI in patient with non-ST elevation ACS. A NT-proBNP level >125.9 pg/mL had sensitivity, specificity, positive predictive value and negative predictive value of 75.7%, 92.3%, 96.6% and 57.1%, respectively. In patients with UA, a NT-proBNP level >123.8 pg/mL had equivalent results of 68.2%, 91.7%, 93.8% and 61.1%, respectively. The area under the curve was 0.891 in non-ST elevation ACS and 0.907 in UA. Elevated NT-proBNP level was also correlated with the severity of culprit artery stenosis and multi-vessel disease. CONCLUSION: Elevated plasma NT-proBNP concentrations were associated with the severity of coronary artery disease in patients with non-ST elevation ACS. In combination with clinical factors, NT-proBNP level will provide a highly discerning tool for early risk stratification and further clinical decisions.
