S6-7 CLINICAL PREDICTORS OF RAPID PROGRESSION OF INCIDENTAL CORONARY ARTERY LESIONS

Abstract

of the 16th Asian Pacific Congress of Cardiology, Taipei, Taiwan, 13–16 December, 2007 35 of plasma CRP and NT pro-BNP versus angiographic severity of coronary atheroscleoris on cardiovascular risk stratification. Background: Plasma NT pro-BNP, CRP and angiographic severity of coronary atherosclerosis have been associated with the long-term outcome of patients with coronary artery disease (CAD). The comparison and the combination of these biomarkers in risk stratification have not been extensively studied. Methods: A total of 345 consecutive patients with stable CAD were recruited after successful PCI. Endpoints were major adverse cardiovascular events (MACEs) and cumulative clinical restenosis rate after 18-36 months of follow-up. Results: Plasma NT pro-BNP and CRP were among the strongest predictors of MACEs, after adjustment for covariates. Gensini angiographic severity score was not significantly associated with the risk of MACEs. Adjusted hazard ratio of MACEs according to combined biomarkers were 2.32 (p=0.05) for elevated CRP only, 5.6 (p=0.001) for elevated NT pro-BNP only and 8.53 (p<0.001) for elevation of both. The joint effect of plasma CRP and NT pro-BNP was confirmed by ROC analysis (AUC:0.82), significantly higher than either biomarker alone or conventional risk factors (AUC:0.67). Significant predictors of clinical restenosis were plasma NT pro-BNP and Gensini score, but not plasma CRP. The combination of NT pro-BNP and Gensini score were the strongest predictors (AUC:0.78) for clinical restenosis. Conclusion: Plasma NT-proBNP, CRP and Gensini score are complementary in risk stratification. The combined use of these biomarkers provides substantial information on top of conventional risk factors in stable CAD patients