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Péptido natriurético tipo B e isquemia en pacientes con enfermedad coronaria estable: datos del estudio Corazón y
Kirsten Bibbins-Domingo1, Maria Ansari, Nelson B Schiller
1Department of Medicine, University of California, San Francisco, USA.
Circulation
|December 10, 2003
Resumen
Los niveles elevados de péptido natriurético tipo B (BNP) están relacionados con la isquemia miocárdica en pacientes con enfermedad coronaria estable. Esta asociación es más fuerte en aquellos con infarto de miocardio previo, lo que explica las limitaciones de la prueba BNP.
Área de la Ciencia:
- Cardiología Cardiología.
- Los biomarcadores también son biomarcadores.
- Pruebas de diagnóstico Pruebas de diagnóstico.
Sus antecedentes:
- Las elevaciones del péptido natriurético tipo B (BNP) indican insuficiencia cardíaca pero carecen de especificidad.
- La isquemia miocárdica también puede elevar los niveles de BNP, lo que complica el diagnóstico en pacientes no sintomáticos.
Objetivo del estudio:
- Investigar la asociación entre los niveles de BNP y la isquemia miocárdica inducible.
- Para determinar si el BNP es un indicador confiable de isquemia en pacientes con enfermedad coronaria estable.
Principales métodos:
- Se midieron los niveles plasmáticos de BNP en pacientes ambulatorios con enfermedad coronaria estable.
- Realizó pruebas de rutina de ejercicio con ecocardiografía de estrés para detectar isquemia inducible.
- Se analizaron los niveles de BNP a través de cuartiles y se correlacionaron con la isquemia, ajustando los factores de confusión.
Principales resultados:
- El 32% de los participantes (113/355) tenía isquemia inducible.
- El cuartil de BNP más alto mostró el doble del riesgo de isquemia inducible (aRR 2.0).
- La asociación fue significativa en pacientes con infarto de miocardio previo (aRR 2.6) pero no en otros.
Conclusiones:
- El aumento del BNP se asocia de forma independiente con la isquemia inducible en la enfermedad coronaria estable.
- Este vínculo es particularmente fuerte en pacientes con antecedentes de infarto de miocardio.
- La falta de especificidad del BNP para la disfunción ventricular puede deberse a la isquemia asociada.
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