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Published on: January 28, 2020
Clinical correlation between N-terminal pro-B-type natriuretic peptide and angiographic coronary atherosclerosis
Demóstenes G L Ribeiro1, Ricardo P Silva1, Daniella R M M Barboza2
1Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
Insights
High N-terminal pro-B-type natriuretic peptide levels are linked to coronary atherosclerosis. This finding helps identify patients with this condition, aiding in better diagnosis and treatment strategies for heart disease.
Area of Science:
- Cardiology
- Biochemistry
- Clinical Medicine
Background:
- Coronary atherosclerosis is a significant risk factor for cardiovascular events.
- Biomarkers for early detection and risk stratification are crucial in managing coronary artery disease.
Purpose of the Study:
- To explore the clinical correlation between angiographic coronary atherosclerosis and N-terminal pro-B-type natriuretic peptide (NT-proBNP).
- To identify independent predictors of coronary atherosclerosis among various clinical and biochemical factors.
Main Methods:
- 153 patients with suspected angina were categorized into two groups: normal coronary arteries or coronary atherosclerosis.
- Analysis included demographic data, clinical presentation, and biochemical markers such as NT-proBNP, cholesterol, creatinine, and fibrinogen.
- Multivariate logistic regression was employed to determine independent predictors.
Main Results:
- Patients with coronary atherosclerosis showed higher rates of diabetes, statin use, systolic dysfunction, elevated NT-proBNP (≥ 250 pg/mL), high fibrinogen (>500 mg/dL), and increased monocytes (≥ 501/mm³).
- Multivariate analysis confirmed NT-proBNP ≥ 250 pg/mL, diabetes mellitus, elevated monocytes, and fibrinogen as independent predictors of coronary atherosclerosis.
- Creatinine levels and systolic dysfunction were not independent predictors.
Conclusions:
- Plasma NT-proBNP concentration ≥ 250 pg/mL is an independent predictor of angiographic coronary atherosclerosis.
- These findings highlight the potential role of NT-proBNP in assessing coronary artery disease severity.
Objectives:
This study aimed to investigate the clinical correlation between angiographic coronary atherosclerosis and N-terminal pro-B-type natriuretic peptide along with other known correlated factors.
Methods:
In total, 153 patients with a diagnostic hypothesis of stable angina, unstable angina or acute myocardial infarction were classified as group A (patients with angiographically normal coronary arteries) or group B (patients with angiographic coronary atherosclerosis). The two groups were analyzed with respect to the following factors: gender, age, body mass index, abdominal circumference, smoking, diabetes mellitus, arterial hypertension, early family history of atherosclerosis, statin use, the presence of metabolic syndrome, clinical presentation and biochemical factors, including cholesterol, creatinine and fibrinogen plasma concentrations, monocyte counts and N-terminal pro-B-type natriuretic peptide.
Results:
Univariate analyses comparing the two groups revealed that group B patients more frequently had diabetes, used statins and had systolic dysfunction, N-terminal pro-B-type natriuretic peptide levels ≥ 250 pg/mL, fibrinogen levels >500 mg/dL and ≥ 501 monocytes/mm3 compared with group A patients (p<0.05). Nevertheless, multivariate logistic regression analysis demonstrated that the independent predictors of angiographic coronary atherosclerosis were an N-terminal pro-B-type natriuretic peptide level ≥ 250 pg/mL, diabetes mellitus and increased monocyte numbers and fibrinogen plasma concentration, regardless of the creatinine level or the presence of systolic dysfunction.
Conclusions:
An N-terminal pro-B-type natriuretic peptide plasma concentration of ≥ 250 pg/mL is an independent predictor of angiographic coronary atherosclerosis.
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