Joint effects of N-terminal pro-B-type-Natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease

被引:12
作者
Dai, Dao-Fu [1 ]
Hwang, Juey-Jen [1 ,2 ]
Lin, Jiunn-Lee [1 ]
Lin, Jou-Wei [2 ]
Hsu, Chih-Neng [2 ]
Lin, Chih-Min [1 ]
Chiang, Fu-Tien [1 ,3 ]
Lai, Ling-Ping [1 ,2 ]
Hsu, Kwan-Lih [1 ]
Tseng, Chuen-Den [1 ]
Tseng, Yung-Zu [1 ]
机构
[1] Natl Taiwan Univ Hosp, Dept Internal Med, Div Cardiovasc, Taipei 100, Taiwan
[2] Natl Taiwan Univ Hosp, Yun Lin Branch, Ctr Cardiovasc, Dou Liou City, Taiwan
[3] Natl Taiwan Univ Hosp, Dept Lab Med, Taipei 100, Taiwan
关键词
brain; C-reactive protein (CRP); coronary artery disease; natriuretic peptides;
D O I
10.1253/circj.72.1316
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background This study was designed to evaluate the joint effects of plasma C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) vs coronary angiographic severity on cardiovascular risk stratification. Methods and Results A total of 345 patients with stable coronary artery disease (CAD) were recruited after successful percutaneous coronary intervention (PCI). Endpoints were major adverse cardiovascular events (MACE) and cumulative clinical restenosis rate after 18-36-month follow-up. Plasma NT-proBNP and CRP levels were among the strongest predictors of MACE. Adjusted hazard ratios of MACE according to combined biomarkers were 2.4 (p=0.05) for elevated CRP only, 5.22 (p<0.001) for elevated NT-proBNP only, and 7.04 (p<0.001) for elevation of both. The differential capacity using both plasma CRP and NT-proBNP in a receiver-operating-characteristics curve analysis (area under curve, AUC: 0.82) was significantly higher than using either biomarker alone or conventional risk factors (AUC: 0.67). Significant predictors of clinical restenosis were plasma NT-proBNP and the Gensini score. The combination of NT-proBNP and the Gensini score was the strongest predictor (AUC: 0.77) for clinical restenosis. Conclusions Plasma NT-proBNP, CRP, and the Gensini score are complementary in risk stratification. Combined use of these biomarkers has provided substantial extra information to conventional risk factors in stable CAD patients.
引用
收藏
页码:1316 / 1323
页数:8
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