title: Brain natriuretic peptide levels during cardiac reperfusion: comparison between percutaneous coronary angioplasty and aorto-coronaric bypass.
abstract: BACKGROUND
  Several studies have documented brain natriuretic peptide (BNP) behavior during cardiac ischemia and after myocardial necrosis. Peptide levels have been shown to be increased during acute phase of cardiac ischemia and during late ventricular remodelling; however, there are fewer data about hormone levels during percutaneous transluminal coronary angioplasty (PTCA) and aorto-coronaric by pass (CABG).
  
  
  METHODS
  Aim of this study was to investigate plasma BNP during acute or sub-acute myocardial ischemia in patients undergoing to PTCA or CABG, taking blood samples before and after both procedures. We studied 59 consecutive subjects, 25 submitted to coronary by-pass and 34 submitted to coronary angioplasty. Blood BNP levels were measured the day before intervention and after 3, 7 and 90 days from the procedures.
  
  
  RESULTS
  Peptide levels were significantly different just before intervention (GABG group 118.7+/-81 pg/ml vs. PTCA group 34.8+/-15 pg/ml, p<0.01). This difference was increased after 3 days (CABG group 403.2+/-185 pg/ml vs. PTCA group 105.3+/-56 pg/ml, p<0.0001) and after 7 days (CABG group 252.2+/-93 pg/ml vs. PTCA group 69.8+/-36 pg/ml, p<0.00001). These results trend to converge after 90 days (CABG group +/-93 pg/ml vs. PTCA group +/-36 pg/ml, p<0.05).
  
  
  CONCLUSIONS
  Plasma BNP shows a different behavior during and after different myocardial reperfusion procedures. PTCA causes only mild and temporary elevation of peptide levels, otherwise CABG demonstrates a more enhancing of BNP release not only in early phase but also after one week; increased levels tend to return towards the reference range after few weeks from cardiac surgery.
authors.affiliation: Department of Internal Medicine and Metabolic Diseases, Section of Cardiology, University of Siena, Ospedale le Scotte, Viale Bracci, 53100, Siena, Italy. palazzuoli2@unisi.it
authors.forename: Alberto
authors.initials: A
authors.lastname: Palazzuoli
authors.forename: Arcangelo
authors.initials: A
authors.lastname: Carrera
authors.forename: Paolo
authors.initials: P
authors.lastname: Calabria
authors.forename: Monica
authors.initials: M
authors.lastname: Pastore
authors.forename: Ilaria
authors.initials: I
authors.lastname: Quatrini
authors.forename: Lucia
authors.initials: L
authors.lastname: Vecchiato
authors.forename: Maria Stella
authors.initials: MS
authors.lastname: Campagna
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Palazzuoli
authors.forename: Ranuccio
authors.initials: R
authors.lastname: Nuti
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015428:Myocardial Reperfusion Injury / Q000097:blood* / Q000628:therapy*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D013997:Time Factors
chemical_list: D020097:Natriuretic Peptide, Brain