Percutaneous coronary revascularization reduces plasma N-terminal pro-B-type natriuretic peptide concentration in stable coronary artery disease.
OBJECTIVE
The purpose of this work was to assess the effect of percutaneous coronary revascularization (PCR) on plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) concentration.


BACKGROUND
Left ventricular (LV) dysfunction is associated with increased plasma natriuretic peptide concentrations. The effect of ischemia resolution on plasma natriuretic peptide is not known.


METHODS
Twenty-six patients with stable angina, normal LV systolic function, and isolated stenoses of the left anterior descending (LAD) coronary artery were studied. All patients had angiographically and physiologically significant lesions defined by cine-angiography and intracoronary pressure wire.


RESULTS
After revascularization, 24 patients demonstrated significant decrease in mean plasma NT-proBNP 8 weeks after PCR (from 177.2 +/- 190.8 pg/ml to 105.0 +/- 92.4 pg/ml, p = 0.03). The mean decrease in log NT-proBNP was 0.533, corresponding to geometric mean decrease of NT-proBNP by a factor of 59% (95% confidence interval 48.2% to 71.4%, p < 0.00005). Reduction in NT-proBNP was independent of change in LV systolic function.


CONCLUSIONS
This study demonstrates that removal of fixed LAD stenosis reduces plasma NT-proBNP concentration. This has implications for interpretation of natriuretic peptide levels in clinical settings and as screening tool for LV systolic dysfunction.
McClure
Samuel J
SJ
Department of Cardiology, Freeman Hospital, Newcastle-upon-Tyne, United Kingdom.
Gall
Scott
S
Schechter
Clyde B
CB
Kearney
Mark
M
Zaman
Azfar G
AG
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000378:metabolism*; D010446:Peptide Fragments / Q000378:metabolism*; D011379:Prognosis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000097:blood* / Q000000981:diagnostic imaging
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain