Brain natriuretic peptide in the prediction of recurrence of angina pectoris.
BACKGROUND
Circulating levels of brain natriuretic peptide (BNP) provide prognostic information for patients with heart failure, but little is known about its prognostic usefulness in patients with stable angina pectoris. We investigated whether BNP could be used as a marker for the prediction of anginal recurrence after successful treatment.


METHODS
Brain natriuretic peptide levels of 77 patients with stable angina pectoris were measured at enrolment and after confirmation of successful treatment (i.e. no anginal attack for at least 6 months: chronic phase) with percutaneous transluminal coronary angioplasty and/or conventional medication. Then, we prospectively followed them up for 25.9 +/- 1.4 months, with the endpoint being a recurrence of anginal attacks.


RESULTS
An anginal attack recurred in seven patients. In patients without recurrence, BNP levels in the chronic phase (21 +/- 12 [median +/- median absolute deviation] pg mL-1) were lower than those measured at enrolment (46 +/- 25 pg mL-1, P < 0.0001), whereas the levels in patients with recurrence increased during the same period (from 36 +/- 16 to 72 +/- 42 pg mL-1, P < 0.05). A univariate analysis revealed that the BNP level measured in the chronic phase was the significant predictor of future anginal recurrence. Analysis of the receiver operating characteristic curve indicated that the cutoff level of BNP in the chronic phase was 68 pg mL-1. The Kaplan-Meier method revealed that the incidence of anginal recurrence was higher in patients with higher (71.4%) than lower levels of BNP (2.9%; P < 0.0001).


CONCLUSIONS
Measurement of BNP levels after successful therapy is clinically useful for the prediction of recurrence of anginal attacks in patients with angina pectoris.
Takase
H
H
Enshu General Hospital, Hamamatsu, Japan. h-takase@ken.ja-shizuoka.or.jp
Toriyama
T
T
Sugiura
T
T
Ueda
R
R
Dohi
Y
Y
D000368:Aged; D000787:Angina Pectoris / Q000097:blood* / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D012307:Risk Factors; D016896:Treatment Outcome
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain