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N-terminal pro-B-type natriuretic peptide as a predictor of repeat coronary revascularization

Cited 2 time in Web of Science Cited 2 time in Scopus
Authors
Sir, Jung-Ju; Chung, Woo-Young; Hwang, Seok-Jae; Kang, Hyun-Jae; Cho, Young-Seok; Koo, Bon-Kwon; Chae, In-Ho; Choi, Dong-Ju; Kim, Hyo-Soo; Sohn, Dae-Won; Kim, Cheol-Ho; Oh, Byung-Hee; Park, Young-Bae; Choi, Yun-Shik
Issue Date
2007-06-05
Publisher
Elsevier
Citation
Int J Cardiol. 2008 ;126(3):322-32.
Keywords
Age FactorsAgedAnalysis of VarianceAngioplasty, Transluminal, Percutaneous Coronary/*methodsBiological Markers/bloodCohort StudiesCoronary AngiographyCoronary Disease/*diagnosis/mortality/*therapyEchocardiography, TransesophagealFemaleHumansMaleMiddle AgedMyocardial Ischemia/diagnosis/mortality/therapyNatriuretic Peptide, Brain/*bloodPeptide Fragments/*bloodPredictive Value of TestsPrognosisROC CurveRetreatmentRisk AssessmentSensitivity and SpecificitySeverity of Illness IndexSex FactorsTomography, Emission-Computed, Single-PhotonTreatment OutcomeVentricular Remodeling/*physiology
Abstract
BACKGROUND: Recent studies suggest that natriuretic peptides are potential biomarkers for myocardial ischemia. However, little is known about the value of NT-proBNP as a predictor of repeat revascularization (RR) at follow-up angiography in patients with normal LV systolic function. METHODS: We collected and analyzed the clinical and angiographic data from 445 consecutive patients (62.5+/-10.1 years; 73% males) who showed normal LV systolic function and no regional wall motion abnormalities on transthoracic echocardiogram performed at baseline and follow-up angiography. RESULTS: Overall, NT-proBNP level on admission for follow-up angiography was significantly higher in patients with RR (n=55) than those without RR (n=390) [92.4 (47.5-178.5) pg/ml vs. 54.8 (30.6-93.1) pg/ml, P<0.001]. In asymptomatic patients, NT-proBNP did not show significant difference between patients with RR and those without RR (P=0.42). An elevated NT-proBNP level, especially in symptomatic patients (n=77) (>87.5 pg/ml as an optimal cut off value) was a strong independent predictor for RR at follow-up angiography (OR, 12.3; 95% CI, 3.25-46.2; P=0.001). NT-proBNP (>122.9 pg/ml) showed high specificity (85.9%) and negative predictive value (91.0%) for predicting RR in overall patients. However, NT-proBNP (>97.0 pg/ml) showed low sensitivity (49.1%) and positive predictive value (23.5%). The areas under the receiver operator characteristic (ROC) curve in predicting RR in overall patients and symptomatic patients were 0.648 (95% CI; 0.564-0.732, P<0.001) and 0.768 (95% CI; 0.653-0.884, P<0.001), respectively. CONCLUSION: Our data show that NT-proBNP level at follow-up is a strong independent predictor for RR especially in symptomatic patients. Although routine measurement may be not useful for predict RR, NT-proBNP may help to identify patients with low risk of repeat revascularization.
ISSN
1874-1754 (Electronic)
Language
English
URI
http://hdl.handle.net/10371/62213
DOI
https://doi.org/10.1016/j.ijcard.2007.04.007
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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