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

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概要

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• 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 either 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.

• 社団法人日本循環器学会の論文
• 2008-07-20

著者

• Hwang Juey-jen

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital:cardiova

• Lin Jiunn-lee

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital

• Tseng Yung-zu

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital

• Lai Ling-ping

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital:cardiova

• Chiang Fu-tien

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital:departme

• Dai Dao-Fu

  Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital

• Lin Jou-Wei

  Cardiovascular Center, National Taiwan University Hospital Yun-Lin Branch

• Hsu Chih-Neng

  Cardiovascular Center, National Taiwan University Hospital Yun-Lin Branch

• Lin Chih-Min

  Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital

• Hsu Kwan-Lih

  Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital

• Tseng Chuen-Den

  Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital

• Hsu Kwan-lih

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital

• Lin Chih-min

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital

• Dai Dao-fu

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital

• Hsu Chih-neng

  Cardiovascular Center National Taiwan University Hospital Yun-lin Branch

• Tseng Chuen-den

  Cardiovascular Division Department Of Internal Medicine National Taiwan University Hospital

• Hwang Juey-Jen

  Cardiovascular Center, National Taiwan University Hospital Yun-Lin Branch, Taiwan

関連論文

• 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
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