Association of N-terminal-pro-B-type natriuretic peptide levels and 2 years clinical outcomes in patients undergoing percutaneous coronary intervention with drug-eluting stents in Asian populations

Abstract

Background: Elevated plasma level of N-Terminal-Pro-B-type Natriuretic Peptide (NT-pro BNP) is known to be associated with significant coronary artery disease.The aim of this study is to evaluate the association between NT-proBNP and long-term clinical outcomes in patients (pts) undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DESs). Methods: The study population consisted of 2,121consecutive patients (pts) undergoing PCI enrolled from November 2005 to August 2010. The pts were divided into four groups according to quartiles of NT-proBNP levels: BNP1 (≤ 61.81 pg/mL), BNP2 (61.81 < NT-proBNP ≤197.70 pg/mL), BNP3 (197.70 < NT-proBNP ≤ 990.70pg/mL), BNP4 (> 990.70pg/mL). Results: At baseline, the prevalence of elderly, male gender, hypertension, diabetes mellitus, peripheral artery disease, chronic kidney disease, smoking, and acute myocardial infarction (AMI) were higher in pts with higher NT-proBNP. At baseline, left main, left descending artery (LAD) and right coronary artery (RCA) as for target lesions, diffuse and small vessel disease were higher in pts with higher NT-proBNP. Clinical outcomes up to 2 years showed that cumulative total death, cardiac death, AMI, repeat PCI and total target lesion revascularization (TLR)-major cardiac adverse event (MACE) were higher in pts with higher NT-proBNP. High NT-proBNP was an independent predictor of TLR-MACE (Adjusted OR: 2.6, 95% CI:1.4-4.7, p>0.001). Conclusions: In our study, the prevalence of conventional risk factors of CVD was higher in pts with higher NT-proBNP. Higher NT-proBNP was associated with adverse long term clinical outcomes up to 2 years. We suggest that elevated NT-proBNP would have important and sensitive role in long term clinical outcomes following PCI.