N-terminal-proB natriuretic peptide in patients with stable coronary artery disease evaluated for ischemia with myocardial perfusion imaging.
BACKGROUND
Natriuretic peptides have emerged in the last years as useful diagnostic and prognostic biomarkers in patients with stable CAD. Myocardial ischemia per se might increase NT-proBNP levels.


OBJECTIVE
The aim of the present study was to determine whether NT-proBNP levels in patients with stable CAD and preserved left ventricular function are elevated and second, to compare NT-proBNP in patients with verified ischemia on myocardial perfusion imaging (MPI) to non-ischemic subjects with known CAD.


METHODS
117 patients were prospectively included, divided in two groups: group A (26 patients)--with normal MPI and without known CAD and group B (91 patients)--with abnormal MPI or known CAD. Patients from group B were further divided according to the presence of ischemia on MPI in non-ischemic (29 pts) and ischemic (62 pts) subgroup.


RESULTS
Levels of NT-proBNP in group B were significantly higher compared to group A (median 53 vs 21 pg/ ml, p = 0.012). End diastolic and end systolic volumes were higher, and ejection fraction after stress and at rest was lower in group B (63% vs 71%, p = 0.0004 and 69% vs 75%, p = 0.008). No significant difference in NT-pro BNP levels (median 48 vs 62 pg/ml, p = 0.5) and functional parameters between the ischemic and nonischemic subjects was found.


CONCLUSIONS
Our data show that patients with stable coronary artery disease and preserved left ventricular function have elevated levels of NT-proBNP. We could not demonstrate that the presence of myocardial ischemia per se was an additional factor leading to increase of the natriuretic propeptide (Tab. 4, Ref. 12).
Majstorov
V
V
Institute of Pathophysiology and Nuclear Medicine, Medical School, University Ss. Cyril and Methodius, Skopje, Republic of Macedonia. venmaj@mt.net.mk
Pop
Gjorcheva D
GD
Vavlukis
M
M
Peovska
I
I
Maksimovik
J
J
Vaskova
O
O
Kuzmanovska
S
S
Zdraveska-Kochovska
M
M
D003324:Coronary Artery Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000503:physiopathology; D003326:Coronary Circulation; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D015899:Tomography, Emission-Computed, Single-Photon
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain