Article ID Journal Published Year Pages File Type
2934461 International Journal of Cardiology 2008 11 Pages PDF
Abstract

BackgroundRecent 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.MethodsWe 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.ResultsOverall, 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.ConclusionOur 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.

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