title: N-terminal pro-B-type natriuretic Peptide predicts significant coronary artery lesion in the unstable angina patients with normal electrocardiogram, echocardiogram, and cardiac enzymes.
abstract: BACKGROUND
  Brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are not specific for ventricular dysfunction and other cardiac processes, such as myocardial ischemia, may also cause elevation of these markers.
  
  
  RESULTS
  To determine whether elevation of NT-proBNP without elevation of cardiac specific markers can predict coronary artery disease (CAD), the serum level of NT-proBNP was measured in 161 patients with unstable angina (61.0+/-8.1 years, male 54.0%) with normal ventricular function (left ventricular ejection fraction >55% and no regional wall motion abnormality by echocardiography) and normal troponin I level (<0.05 ng/ml). In these patients, levels of C-reactive protein and myoglobin were normal and none had Q wave on electrocardiographic (ECG). The NT-proBNP level was higher in patients with CAD (n=74) than in patients without CAD (n=87) (173.1+/-231.6 vs 68.1+/-62.5 pg/ml, p<0.001). At the standard cut-off point of >200 pg/ml, elevated NT-proBNP level shows high probability of CAD (odds ratio, 10.1; 95% confidence interval, 2.6-38.7, p=0.001). The NT-proBNP level positively correlated with the extent of CAD (r=0.329, p=0.001). In multivariate analysis, the NT-proBNP was an independent predictor of CAD.
  
  
  CONCLUSIONS
  These results suggested that NT-proBNP is a useful screening test for CAD in the unstable angina patients with normal ECG, echocardiogram and cardiac enzyme levels.
authors.affiliation: Department of Cardiovascular Medicine, The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Science, Gwangju, South Korea.
authors.forename: Seo Na
authors.initials: SN
authors.lastname: Hong
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Sang Yub
authors.initials: SY
authors.lastname: Lim
authors.forename: Yong Sook
authors.initials: YS
authors.lastname: Kim
authors.forename: Kyung Ho
authors.initials: KH
authors.lastname: Yun
authors.forename: Dong Koo
authors.initials: DK
authors.lastname: Kang
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Yeon Sang
authors.initials: YS
authors.lastname: Lee
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Il Seok
authors.initials: IS
authors.lastname: Son
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000789:Angina, Unstable / Q000175:diagnosis*; D015415:Biomarkers / Q000097:blood; D004796:Clinical Enzyme Tests; D003324:Coronary Artery Disease / Q000175:diagnosis*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015999:Multivariate Analysis; D009206:Myocardium / Q000201:enzymology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain