Document Detail

Diagnostic implication of change in b-type natriuretic peptide (BNP) for prediction of subsequent target lesion revascularization following silorimus-eluting stent deployment.
MedLine Citation:
PMID:  23302112     Owner:  NLM     Status:  Publisher    
BACKGROUND: Restenosis after percutaneous coronary intervention (PCI) is still a great concern even in the recent drug-eluting stent (DES) era. As less invasive and sensitive parameter to detect restenosis is needed, this study was aimed to assess whether the clinical implication of temporal change in plasma BNP levels might be a useful indicator of restenosis after DES implantation. METHODS AND RESULTS: 847 consecutive patients who underwent elective PCI using silorimus-eluting sent (SES) between 2005 and 2009 were analyzed. Primary endpoint was subsequent target-lesion revascularization (TLR) after PCI. There was no significant difference in either baseline (TLR+vs. TLR-: 107.2±172.2 vs. 96.2±175.5pg/mL, P=0.53) or follow-up plasma B-type natriuretic peptide (BNP) levels (TLR+vs. TLR-: 88.6±111.6 vs. 68.5±226.0pg/mL, P=0.35) between patients with and without subsequent TLR. Conversely, ratio of follow-up to baseline BNP was significantly higher in patients with TLR (TLR+vs. TLR-: 1.55±1.58 vs. 1.07±1.04, P<0.001). Multivariate analysis using logistic regression showed log transformed BNP-ratio was an independent predictor of TLR (adjusted odds ratio (aOR): 1.94, 95%CI: 1.42-2.66, P<0.001). A closer relationship between BNP elevation greater than 2-fold and subsequent TLR was found (aOR: 2.69, 95%CI: 1.27-5.69, P<0.009). Furthermore, propensity score matching analysis showed that the incidence of subsequent TLR was significantly higher in patients with BNP elevation (P<0.001). CONCLUSION: Serial measurement of plasma BNP levels and its change might be a useful approach to predict restenosis in patients without typical chest symptoms receiving SES.
Eriko Hasumi; Hiroshi Iwata; Takahide Kohro; Ichiro Manabe; Koichiro Kinugawa; Naho Morisaki; Jiro Ando; Daigo Sawaki; Masao Takahashi; Hideo Fujita; Hiroshi Yamashita; Junya Ako; Yasunobu Hirata; Issei Komuro; Ryozo Nagai
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-7
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo, Hongo 7-3-1, Bunkyo-ku, Tokyo 113-8611, Japan.
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