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B-type natriuretic peptide as an independent predictor of coronary disease extension in non-ST elevation coronary syndromes with preserved systolic function.
Eur J Prev Cardiol. 2012 Jun; 19(3):366-73.EJ

Abstract

OBJECTIVE

B-type natriuretic peptide (BNP) has been employed as a risk marker in patients with coronary artery disease (CAD) with ST elevation and non-ST elevation. It is not yet established if early BNP measurements provide additional information to troponin and electrocardiographic analysis in patients without ventricular enlargement and systolic dysfunction.

DESIGN

This study compared BNP levels in patients with stable angina (SA) and acute coronary syndromes with non-ST elevation in relation to angiographic lesions (NSTEMI-ACS). Moreover, the diagnostic utility of BNP was determined using the receiver operating characteristic curve.

PATIENTS

280 patients with CAD without ST elevation and preserved systolic function were studied. BNP samples were measured in all recruited patients within 24 hours of hospitalization.

RESULTS

BNP values increased progressively with the severity of diagnosis: SA (n = 85; 50.4 ± 50 pg/ml) NSTEMI-ACS (n = 195; 283 ± 269 pg/ml; p < 0.0001). The analysis of BNP in relation to the number of involved vessels demonstrated significantly increased levels in patients with multivessel disease compared to patients with 1- or 2-vessel disease (p < 0.001 and p < 0.003). Values of BNP >80 pg/ml were shown to be able to predict CAD severity and coronary vessel involvement (AUC = 0.80; p = 0.0001) with a sensitivity of 78% and a specificity of 72%. In multivariate analysis, BNP levels >80 pg/ml, CAD history, and ST deviation >2 mm were confirmed as independent predictors of CAD severity.

CONCLUSIONS

Circulating BNP levels appear elevated in NSTEMI-ACS, without left ventricular systolic dysfunction. A BNP cut-off value of 80 pg/ml is a good predictor of CAD extension.

Authors+Show Affiliations

Department of Internal Medicine and Metabolic Disease Cardiology Section, University of Siena, Italy. palazzuoli2@unisi.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

21464097

Citation

Palazzuoli, Alberto, et al. "B-type Natriuretic Peptide as an Independent Predictor of Coronary Disease Extension in non-ST Elevation Coronary Syndromes With Preserved Systolic Function." European Journal of Preventive Cardiology, vol. 19, no. 3, 2012, pp. 366-73.
Palazzuoli A, Caputo M, Fineschi M, et al. B-type natriuretic peptide as an independent predictor of coronary disease extension in non-ST elevation coronary syndromes with preserved systolic function. Eur J Prev Cardiol. 2012;19(3):366-73.
Palazzuoli, A., Caputo, M., Fineschi, M., Navarri, R., Calabrò, A., Cameli, M., Campagna, M. S., Franci, B., Pierli, C., Nuti, R., & Maisel, A. (2012). B-type natriuretic peptide as an independent predictor of coronary disease extension in non-ST elevation coronary syndromes with preserved systolic function. European Journal of Preventive Cardiology, 19(3), 366-73. https://doi.org/10.1177/1741826711406608
Palazzuoli A, et al. B-type Natriuretic Peptide as an Independent Predictor of Coronary Disease Extension in non-ST Elevation Coronary Syndromes With Preserved Systolic Function. Eur J Prev Cardiol. 2012;19(3):366-73. PubMed PMID: 21464097.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B-type natriuretic peptide as an independent predictor of coronary disease extension in non-ST elevation coronary syndromes with preserved systolic function. AU - Palazzuoli,Alberto, AU - Caputo,Maria, AU - Fineschi,Massimo, AU - Navarri,Romina, AU - Calabrò,Anna, AU - Cameli,Matteo, AU - Campagna,Maria Stella, AU - Franci,Beatrice, AU - Pierli,Carlo, AU - Nuti,Ranuccio, AU - Maisel,Alan, Y1 - 2011/04/04/ PY - 2011/4/6/entrez PY - 2011/4/6/pubmed PY - 2012/9/20/medline SP - 366 EP - 73 JF - European journal of preventive cardiology JO - Eur J Prev Cardiol VL - 19 IS - 3 N2 - OBJECTIVE: B-type natriuretic peptide (BNP) has been employed as a risk marker in patients with coronary artery disease (CAD) with ST elevation and non-ST elevation. It is not yet established if early BNP measurements provide additional information to troponin and electrocardiographic analysis in patients without ventricular enlargement and systolic dysfunction. DESIGN: This study compared BNP levels in patients with stable angina (SA) and acute coronary syndromes with non-ST elevation in relation to angiographic lesions (NSTEMI-ACS). Moreover, the diagnostic utility of BNP was determined using the receiver operating characteristic curve. PATIENTS: 280 patients with CAD without ST elevation and preserved systolic function were studied. BNP samples were measured in all recruited patients within 24 hours of hospitalization. RESULTS: BNP values increased progressively with the severity of diagnosis: SA (n = 85; 50.4 ± 50 pg/ml) NSTEMI-ACS (n = 195; 283 ± 269 pg/ml; p < 0.0001). The analysis of BNP in relation to the number of involved vessels demonstrated significantly increased levels in patients with multivessel disease compared to patients with 1- or 2-vessel disease (p < 0.001 and p < 0.003). Values of BNP >80 pg/ml were shown to be able to predict CAD severity and coronary vessel involvement (AUC = 0.80; p = 0.0001) with a sensitivity of 78% and a specificity of 72%. In multivariate analysis, BNP levels >80 pg/ml, CAD history, and ST deviation >2 mm were confirmed as independent predictors of CAD severity. CONCLUSIONS: Circulating BNP levels appear elevated in NSTEMI-ACS, without left ventricular systolic dysfunction. A BNP cut-off value of 80 pg/ml is a good predictor of CAD extension. SN - 2047-4881 UR - https://www.unboundmedicine.com/medline/citation/21464097/B_type_natriuretic_peptide_as_an_independent_predictor_of_coronary_disease_extension_in_non_ST_elevation_coronary_syndromes_with_preserved_systolic_function_ L2 - https://journals.sagepub.com/doi/10.1177/1741826711406608?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -