Usefulness of Serum N-Terminal Pro–Brain Natriuretic Peptide to Predict In-Stent Restenosis in Patients With Preserved Left Ventricular Function and Normal Troponin I Levels

• Published in: The American journal of cardiology 2007-04, Vol.99 (8), p.1051-1054
• Main Authors: Hong, Seo Na, MD, Ahn, Youngkeun, MD, Yoon, Nam Sik, MD, Lee, Ki Hong, MD, Kim, Yong Sook, PhD, Hwang, Seon Ho, MD, Lee, Sang Rok, MD, Kim, Kye Hun, MD, Park, Hyung Wook, MD, Hong, Young Joon, MD, Kim, Ju Han, MD, Jeong, Myung Ho, MD, Cho, Jeong Gwan, MD, Park, Jong Chun, MD, Kang, Jung Chaee, MD
• Format: Article
• Language: English
• Subjects: Angina Pectoris - therapy; Angina, Unstable - therapy; Angioplasty, Balloon, Coronary; Biomarkers - blood; Body fluids; Cardiology; Cardiovascular; Cardiovascular disease; Clinical outcomes; Coronary Angiography; Coronary Disease - therapy; Coronary Restenosis - etiology; Coronary vessels; Female; Follow-Up Studies; Forecasting; Heart; Humans; Male; Medical imaging; Middle Aged; Myocardial Infarction - therapy; Natriuretic Peptide, Brain - blood; Patients; Peptide Fragments - blood; Peptides; Prospective Studies; Protein Precursors - blood; Stents; Stroke Volume - physiology; Survival Rate; Troponin I - blood; Ventricular Function, Left - physiology
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2006.11.069

The level of N-terminal pro–B-type natriuretic peptide (NT–pro-BNP) is a strong predictor of mortality in patients with acute coronary syndrome and may be a strong prognostic marker in patients with chronic coronary artery disease. We investigated whether NT–pro-BNP could predict in-stent restenosis (ISR) in asymptomatic patients with preserved left ventricular (LV) systolic function who underwent percutaneous coronary intervention. We measured serum NT–pro-BNP levels in 249 patients (61 ± 9 years of age; 73% men) with preserved LV systolic function (ejection fraction >50%) who underwent follow-up coronary angiography. Initial diagnoses were stable angina in 50 (20%), unstable angina in 133 (53%), and myocardial infarction in 66 (27%). Baseline characteristics between groups with ISR (n = 92) and without ISR (n = 157) were similar. The level of NT–pro-BNP was higher in patients with ISR than in those without ISR (222 ± 327 vs 94 ± 136 pg/ml, p = 0.001). In the ISR group, NT–pro-BNP level was higher in patients with left anterior descending coronary artery ISR (n = 53, 312 ± 479 pg/ml) than in those with left circumflex coronary artery ISR (n = 19, 115 ± 98 pg/ml, p = 0.018). At the standard cutoff of >200 pg/ml, a high NT–pro-BNP level indicated a high probability of ISR (odds ratio 2.18, 95% confidence interval 1.0 to 4.5, p = 0.038). In multivariate analysis, NT–pro-BNP level was an independent predictor for ISR. In conclusion, NT–pro-BNP could be a predictor of ISR in asymptomatic patients with preserved LV systolic function.