Rise and fall of B-type natriuretic peptide levels in patients with coronary artery disease and normal left ventricular function after cardiac revascularization.
BACKGROUND
Recently, it was shown that B-type natriuretic peptide levels are increased in patients with acute coronary syndromes.


OBJECTIVE
To assess the relation between B-type natriuretic peptide and ischemia in patients with stable and unstable angina pectoris with normal left ventricular function in relation to the extent of ischemia and response to revascularization.


METHODS
Fifty-nine consecutive patients were enrolled in the study, patients were divided into two groups: stable angina patients (group I, n=18), and unstable coronary patients (group II, n=41). Baseline characteristics were compared with 15 age-matched and sex-matched participants. B-type natriuretic peptide levels were measured at baseline and 3, 7 and 90 days after coronary revascularization in group I and II.


RESULTS
Patients with unstable angina pectoris had increased B-type natriuretic peptide levels compared with stable angina pectoris patients (B-type natriuretic peptide levels: controls 15.5+/-13 pg/ml, stable angina pectoris group 28.4+/-19 pg/ml, unstable angina pectoris group 104+/-81 pg/ml; P<0.01). A relationship between the number of affected coronary vessels and B-type natriuretic peptide was assessed (one-vessel 29.9+/-21 pg/ml, two-vessel 93.8+/-87 pg/ml, three-vessel 119+/-88 pg/ml; P<0.01). After revascularization, B-type natriuretic peptide levels decreased in groups I and II (25+/-20 vs. 39+/-28 pg/ml) and were similar after 90 days in percutaneous transluminal coronary angiograghy and in coronary artery bypass grafting groups (percutaneous transluminal coronary angiography 26+/-22 pg/ml, coronary artery bypass grafting 36+/-26 pg/ml; NS).


CONCLUSIONS
B-type natriuretic peptide levels increase in unstable angina pectoris patients and are linked to the extent of coronary disease in patients with normal left ventricular systolic function, and returned to baseline level after surgical or catheter revascularization.
Palazzuoli
Alberto
A
Department of Internal Medicine, Endocrine-Metabolic Diseases, Section of Cardiology, University of Siena, Siena, Italy. palazzuoli2@unisi.it
Poldermans
Don
D
Capobianco
Stefano
S
Giannotti
Giovanna
G
Iovine
Francesca
F
Campagna
Maria Stella
MS
Calabrò
Anna
A
Bagaglia
Simone
S
Nuti
Ranuccio
R
D000368:Aged; D000787:Angina Pectoris / Q000503:physiopathology* / Q000601:surgery; D000789:Angina, Unstable / Q000503:physiopathology / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D016277:Ventricular Function, Left / Q000502:physiology*
D015415:Biomarkers; D020097:Natriuretic Peptide, Brain