does serum N-terminal pro-brain natriuretic peptide level predict the severity of angiographic lesions in patients with acutecoronary syndrome

Backgrounds:Serum N-terminal pro-brain natriuretic peptide (NT-proBNP), a polypeptide secreted byventricular myocytes in response to stretch, was suggested as a predictor of adverse prognosisof the acute coronary syndrome (ACS). We examined the association between NT-proBNPlevel and angiographic findings in ACS patients to determine whether it could be used as apredictor of the severity of angiographic lesions.Materials and Methods:This cross-sectional study was performed on 126 patients with chest pain or other ischemicheart symptoms suggestive of ACS. VenousBlood samples were drawn to measure serum levels of NT-proBNP, troponin T, and highsensitivityC-reactive protein (hs-CRP). Afterward, coronary angiography was performed andthe patients were categorized into four groups according to the number of coronary vesselswith significant stenosis. The severity of angiographic lesions was assessed with the Gensiniscoring system.Results:According to angiographic diagnosis, 11 (8.7%) patients had normal coronary arteries (nocoronary artery disease [CAD]) and 115 (91.3%) had CAD, of whom 108 (85.7%) hadobstructive CAD and 7 (5.6%) had minimal CAD. The serum NT-proBNP concentration washigher in the CAD group than in the non-CAD group in patients with left ventricular ejectionfraction greater than 50% (p value = 0.04). A progressive significant increase in the NTproBNPconcentration according to the number of involved vessels was reported afteradjustment for sex and age. Furthermore, the Receiver Operating Characteristic Curve (ROC)analysis indicated that an NT-proBNP cut-point of 400 pg/ml could predict obstructive CADwith a sensitivity of 65% and a specificity of 78%.Conclusion:Higher levels of NT-proBNP among our ACS patients were associated with the severity ofangiographic lesions in terms of both the Gensini score and the number of involved vessels.This finding underscores the potential role of NT-proBNP in predicting the severity of CADbefore performing angiograpy.

کلیدواژه ها:

Natriuretic peptide ، brain ، Acute coronary syndrome ، Risk assessment