慢性的な安定性アンギナを持つ患者のN-ターミナル前脳ナトリウレチンペプチドの予後値
Gjin Ndrepepa1, Siegmund Braun, Kathrin Niemöller
1Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Germany.
Circulation
|September 28, 2005
まとめ
N-ターミナル前脳ナトリウレチンペプチド (NT-proBNP) レベルは,慢性的な安定性胸痛を有する患者の強力な予後マーカーです. 高濃度のNT-proBNPは,これらの患者の死亡リスクの増加と有意に相関しています.
科学分野:
- 心臓病学 心臓病学
- バイオマーカーの研究
- クリニカル・プログノスティクス
背景:
- 慢性的な安定性アンギナには,よく定義された予後バイオマーカーがない.
- 予後を評価することは,アンギナ患者の治療決定を導くために非常に重要です.
研究 の 目的:
- 予後マーカーとしてN-ターミナルプロ脳ナトリウレチンペプチド (NT-proBNP) を調査する.
- 冠動脈ステントを挿入する慢性的な安定性アンギナ患者のNT-proBNPを評価する.
主な方法:
- プラズマNT-proBNP濃度測定は,安定した胸痛を患った1059人の患者に実施した.
- 冠動脈動脈検査で,有意な冠動脈疾患が確認されました.
- 死亡率 (プライマリーエンドポイント) について,患者さんを平均3.6年間追跡した.
主要な成果:
- 高濃度のNT-proBNPは,あらゆる原因による死亡率の増加と強く相関していた.
- カプラン・マイヤー分析では,NT-proBNP四分位数 (P<0.001) の増加とともに,5年後の死亡率が著しく高かったことが示された.
- NT-proBNPは死亡率の最も強い予測因子でした (aHRは最高四分位数と最低四分位数で5.83).
結論:
- 循環中のNT-proBNPレベルは,強力な予後バイオマーカーとして機能します.
- NT-proBNPは,安定したアンギナ患者の心血管疾患による死亡率を含む死亡率を効果的に予測します.
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