NT-proANP and NT-proBNP circulating levels as predictors of cardiovascular outcome following coronary stent implantation.

Abstract

BACKGROUND:

Natriuretic peptides are diagnostic/prognostic biomarkers in major cardiovascular diseases. We aimed at assessing the predictive role of N-terminal pro-A-type (NT-proANP) and pro-B-type (NT-proBNP) natriuretic peptides levels toward cardiovascular outcome in both stable and unstable coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in a non-primary PCI setting.

METHODS:

A total of 395 patients undergoing PCI with stent implantation for either stable angina (SA) or non ST-elevation acute coronary syndrome (NSTE-ACS) were enrolled. Pre-procedural NT-proANP and NT-proBNP levels were measured. Occurrence of major adverse cardiac events (MACEs), composite of cardiac death, non-fatal myocardial infarction, and clinically driven target lesion revascularization (c-TLR), was the endpoint of the study. Follow up mean time was 48.53±14.69months.

RESULTS:

MACEs occurred in forty-four patients (11%) during follow up. Both NT-proANP levels [3170 (2210-4630) vs 2283 (1314-3913) fmol/mL, p=0.004] and NT-proBNP levels [729 (356-1353) vs 511 (267-1006) fmol/mL, p=0.04] were significantly higher in patients with MACEs compared to patients without MACEs. Similar results were found when considering hard MACEs (myocardial infarction and cardiac death). NT-proANP levels were significantly higher in patients with c-TLR compared with patients without c-TLR [3705 (2766-5184) vs 2343 (1340-3960) fmol/mL, p=0.021]. At multivariate analysis, NT-proANP levels were a significant predictor of MACEs (HR 1.09, 95% CI 1.03-1.18, p=0.04). Kaplan-Meyer curves revealed that patients with elevated NT-proANP levels (>2.100fmol/mL) had a lower MACE free survival (p=0.003).

CONCLUSIONS:

Both NT-proANP and NT-proBNP levels were higher in CAD patients experiencing MACEs following PCI in a non-primary setting. Notably, only NT-proANP levels significantly affected prognosis after PCI.

• Authors: Giampaolo Niccoli, Micaela Conte, Simona Marchitti, Rocco A Montone, Francesco Fracassi, Rocco Grippo, Marco Roberto, Francesco Burzotta, Carlo Trani, Antonio Maria Leone, Franca Bianchi, Sara Di Castro, Massimo Volpe, Filippo Crea, Speranza Rubattu
• Journal: Cardiovascular revascularization medicine : including molecular interventions (Cardiovasc Revasc Med) 2016 Apr-May Vol. 17 Issue 3 Pg. 162-8 ISSN: 1878-0938 [Electronic] United States
• PMID: 26987266 (Publication Type: Journal Article)
• Copyright: Copyright © 2016 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers
• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain
• Atrial Natriuretic Factor

Topics

• Aged
• Aged, 80 and over
• Angina, Stable (blood, diagnosis, mortality, therapy)
• Atrial Natriuretic Factor (blood)
• Biomarkers (blood)
• Coronary Artery Disease (blood, diagnosis, mortality, therapy)
• Disease-Free Survival
• Female
• Humans
• Kaplan-Meier Estimate
• Male
• Middle Aged
• Multivariate Analysis
• Natriuretic Peptide, Brain (blood)
• Non-ST Elevated Myocardial Infarction (blood, diagnosis, mortality, therapy)
• Peptide Fragments (blood)
• Percutaneous Coronary Intervention (adverse effects, instrumentation, mortality)
• Proportional Hazards Models
• Recurrence
• Risk Factors
• Stents
• Time Factors
• Treatment Outcome
• Up-Regulation