The Plasma Level of N-terminal Pro B-type Natriuretic Peptide(NT-proBNP) for Severity of Coronary Artery Stenosis and Early Risk Stratification in Patients with Non ST Elevation Acute Coronary Syndrome

Abstract

Background and Objectives:Although elevations of plasma N-terminal pro B-type natriuretic peptide (NTproBNP) concentration have been shown to be prognostically significant in patients with non-ST elevation acute coronary syndrome (ACS), the relation between the plasma level of NT-proBNP and the severity of coronary disease remains unknown. Subjects and Methods:The NT-proBNP concentration was analyzed in 50 patients with non-ST elevation ACS. We compared plasma NT-proBNP levels and treatment method (medical treatment vs. percutaneous coronary intervention [PCI]). Results:In patients with non-ST elevation ACS, NT-proBNP levels were significantly higher in the PCI (n=37) group than in the medical treatment (n=13) group (296.6 vs. 76.3 pg/mL; p 125.9 pg/mL had sensitivity, specificity, positive predictive value and negative predictive value of 75.7%, 92.3%, 96.6% and 57.1%, respectively. In patients with UA, a NT-proBNP level >123.8 pg/mL had equivalent results of 68.2%, 91.7%, 93.8% and 61.1%, respectively. The area under the curve was 0.891 in non-ST elevation ACS and 0.907 in UA. Elevated NT-proBNP level was also correlated with the severity of culprit artery stenosis and multi-vessel disease. Conclusion:Elevated plasma NT-proBNP concentrations were associated with the severity of coronary artery disease in patients with non-ST elevation ACS. In combination with clinical factors, NT-proBNP level will provide a highly discerning tool for early risk stratification and further clinical decisions. (Korean Circulation J 2004;34 (2):133-141)