Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease
Journal
Circulation Journal
Journal Volume
72
Journal Issue
8
Pages
1316-1323
Date Issued
2008
Author(s)
Dai D.-F.
Hsu C.-N.
Lin C.-M.
Hsu K.-L.
Tseng C.-D.
Tseng Y.-Z.
Abstract
Background: This study was designed to evaluate the joint effects of plasma C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) vs coronary angiographic severity on cardiovascular risk stratification. Methods and Results: A total of 345 patients with stable coronary artery disease (CAD) were recruited after successful percutaneous coronary intervention (PCI). Endpoints were major adverse cardiovascular events (MACE) and cumulative clinical restenosis rate after 18-36-month follow-up. Plasma NT-proBNP and CRP levels were among the strongest predictors of MACE. Adjusted hazard ratios of MACE according to combined biomarkers were 2.4 (p=0.05) for elevated CRP only, 5.22 (p<0.001) for elevated NT-proBNP only, and 7.04 (p<0.001) for elevation of both. The differential capacity using both plasma CRP and NT-proBNP in a receiver-operating-characteristics curve analysis (area under curve, AUC: 0.82) was significantly higher than using eiflier biomarker alone or conventional risk factors (AUC: 0.67). Significant predictors of clinical restenosis were plasma NT-proBNP and the Gensini score. The combination of NT-proBNP and the Gensini score was the strongest predictor (AUC: 0.77) for clinical restenosis. Conclusions: Plasma NT-proBNP, CRP, and the Gensini score are complementary in risk stratification. Combined use of these biomarkers has provided substantial extra information to conventional risk factors in stable CAD patients.
SDGs
Other Subjects
amino terminal pro brain natriuretic peptide; biological marker; C reactive protein; adult; aged; angiocardiography; article; cardiovascular disease; cardiovascular risk; coronary artery disease; disease severity; female; gensini score; human; major clinical study; male; restenosis; risk assessment; risk factor; scoring system; transluminal coronary angioplasty; Aged; Angioplasty, Transluminal, Percutaneous Coronary; Biological Markers; C-Reactive Protein; Cardiovascular Diseases; Coronary Angiography; Coronary Artery Disease; Coronary Restenosis; Disease-Free Survival; Female; Humans; Male; Middle Aged; Natriuretic Peptide, Brain; Peptide Fragments; Predictive Value of Tests; Prospective Studies; Risk Assessment; Risk Factors; ROC Curve; Severity of Illness Index; Time Factors
Type
journal article