B-type natriuretic peptide as a marker of asymptomatic re-stenosis after coronary implantation of a paclitaxel-eluting stent.
BACKGROUND
The aim of the present study was the detection of asymptomatic coronary re-stenosis after percutaneous coronary intervention (PCI).


METHODS
We studied 26 subjects who had been recently implanted with a paclitaxel-eluting coronary stent by both a conventional exercise test and the determination of plasma B-type natriuretic peptide (BNP) levels.


RESULTS
At control coronary angiography, nine months after initial PCI, six patients had re-stenosis and 20 were re-stenosis free. We found that re-stenosis was best predicted by the combination of a basal plasma BNP level > or = 50 pg/ml and a positive or uncertain conventional exercise test (positive likelihood ratio of the combination = 10). The best predictor of absence of re-stenosis was a low (< 50 pg/ml) plasma BNP level (negative likelihood ratio = 0.26).


CONCLUSIONS
Accordingly, basal BNP level testing can be recommended in the follow-up evaluation of coronary patients after PCI, to improve both the detection and the exclusion of asymptomatic re-stenosis.
Lo Mauro
Renato
R
Unità Operativa di Cardiologia II, Ospedale Vincenzo Cervello, Via Trabucco 180, Palermo, Italy. relomauro@virgilio.it
Arcoleo
Francesco
F
Lo Giudice
Angela
A
Picone
Antonina
A
Schirosa
Maurizio
M
Raspanti
Giacinto
G
Cillari
Enrico
E
Enia
Francesco
F
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D015415:Biomarkers / Q000097:blood; D002317:Cardiovascular Agents / Q000008:administration & dosage*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D023921:Coronary Stenosis / Q000097:blood / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000628:therapy*; D054855:Drug-Eluting Stents; D005080:Exercise Test; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D017239:Paclitaxel / Q000008:administration & dosage*; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D002317:Cardiovascular Agents; D020097:Natriuretic Peptide, Brain; D017239:Paclitaxel