Document Detail

N-terminal pro-B-type natriuretic peptide as a predictor of repeat coronary revascularization.
MedLine Citation:
PMID:  17544525     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent studies suggest that natriuretic peptides are potential biomarkers for myocardial ischemia. However, little is known about the value of NT-proBNP as a predictor of repeat revascularization (RR) at follow-up angiography in patients with normal LV systolic function. METHODS: We collected and analyzed the clinical and angiographic data from 445 consecutive patients (62.5+/-10.1 years; 73% males) who showed normal LV systolic function and no regional wall motion abnormalities on transthoracic echocardiogram performed at baseline and follow-up angiography. RESULTS: Overall, NT-proBNP level on admission for follow-up angiography was significantly higher in patients with RR (n=55) than those without RR (n=390) [92.4 (47.5-178.5) pg/ml vs. 54.8 (30.6-93.1) pg/ml, P<0.001]. In asymptomatic patients, NT-proBNP did not show significant difference between patients with RR and those without RR (P=0.42). An elevated NT-proBNP level, especially in symptomatic patients (n=77) (>87.5 pg/ml as an optimal cut off value) was a strong independent predictor for RR at follow-up angiography (OR, 12.3; 95% CI, 3.25-46.2; P=0.001). NT-proBNP (>122.9 pg/ml) showed high specificity (85.9%) and negative predictive value (91.0%) for predicting RR in overall patients. However, NT-proBNP (>97.0 pg/ml) showed low sensitivity (49.1%) and positive predictive value (23.5%). The areas under the receiver operator characteristic (ROC) curve in predicting RR in overall patients and symptomatic patients were 0.648 (95% CI; 0.564-0.732, P<0.001) and 0.768 (95% CI; 0.653-0.884, P<0.001), respectively. CONCLUSION: Our data show that NT-proBNP level at follow-up is a strong independent predictor for RR especially in symptomatic patients. Although routine measurement may be not useful for predict RR, NT-proBNP may help to identify patients with low risk of repeat revascularization.
Jung-Ju Sir; Woo-Young Chung; Seok-Jae Hwang; Hyun-Jae Kang; Young-Seok Cho; Bon-Kwon Koo; In-Ho Chae; Dong-Ju Choi; Hyo-Soo Kim; Dae-Won Sohn; Cheol-Ho Kim; Byung-Hee Oh; Young-Bae Park; Yun-Shik Choi
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2007-06-04
Journal Detail:
Title:  International journal of cardiology     Volume:  126     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2008 Jun 
Date Detail:
Created Date:  2008-05-16     Completed Date:  2008-07-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  322-32     Citation Subset:  IM    
Department of Internal Medicine, Inje University College of Medicine, Cardiovascular Center, Seoul Paik Hospital, South Korea.
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MeSH Terms
Age Factors
Analysis of Variance
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Biological Markers / blood
Cohort Studies
Coronary Angiography
Coronary Disease / diagnosis*,  mortality,  therapy*
Echocardiography, Transesophageal
Middle Aged
Myocardial Ischemia / diagnosis,  mortality,  therapy
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Predictive Value of Tests
ROC Curve
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Sex Factors
Tomography, Emission-Computed, Single-Photon
Treatment Outcome
Ventricular Remodeling / physiology*
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain

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