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Heart 2009;95:297-303 doi:10.1136/hrt.2008.145425
  • Original article
  • Coronary artery disease

Limited utilities of N-terminal pro B-type natriuretic peptide and other newer risk markers compared with traditional risk factors for prediction of significant angiographic lesions in stable coronary artery disease

  1. A Peer1,
  2. G Falkensammer2,
  3. H Alber1,
  4. A Kroiss3,
  5. A Griesmacher2,
  6. H Ulmer4,
  7. O Pachinger1,
  8. J Mair1
  1. 1
    Department of Cardiology, Innsbruck Medical University, Austria
  2. 2
    Central Institute for Medical and Chemical Laboratory Diagnostics, Innsbruck Medical University, Austria
  3. 3
    Department of Nuclear Medicine, Innsbruck Medical University, Austria
  4. 4
    Department of Medical Biostatistics, Informatics and Health Economics, Innsbruck Medical University, Austria
  1. Dr Johannes Mair, Universitaetsklinik fuer Innere Medizin III-Kardiologie, Anichstrasse 35, A-6020 Innsbruck, Austria; Johannes.Mair{at}i-med.ac.at
  • Accepted 8 July 2008
  • Published Online First 15 August 2008

Abstract

Objective: To investigate the usefulness of N-terminal pro-brain natriuretic peptide (NT-proBNP) as a predictive marker for angiographically significant coronary artery disease (CAD) and CAD severity compared with other newer biochemical risk markers and classic risk factors in patients with clinically suspected CAD.

Design: Cross-sectional evaluation of NT-proBNP in a large consecutive series of patients without a history of myocardial infarction referred for elective coronary angiography (CAG) between March 2004 and January 2005. The value of NT-proBNP for predicting CAD was assessed and compared with high sensitivity C-reactive protein (hs-CRP), γ-glutamyltransferase (GGT) and traditional risk factors.

Setting: Tertiary care centre, Department of Cardiology, Innsbruck Medical University, Austria.

Patients: 561 men and 287 women aged between 20–86 years (median 65 years).

Interventions: None.

Main outcome measures: Association of NT-proBNP with the severity of CAD, left ventricular dysfunction and comparison of predictive values of NT-proBNP, hs-CRP, GGT and traditional CAD risk factors.

Results: Of all tested newer biochemical risk markers NT-proBNP performed best. In a multinomial logistic regression model NT-proBNP but not hs-CRP or GGT was significantly associated with three-vessel CAD adjusted for age, sex, ventricular, renal function and classic risk factors (odds ratio = 1.667; 95% CI 1.003 to 2.772; p = 0.049). However, NT-proBNP had no additive predictive value to traditional cardiovascular risk factors for the prediction of angiographically significant CAD in a binary logistic regression model.

Conclusions: The predictive value of NT-proBNP for CAD severity is better than that of hs-CRP or GGT. However, NT-proBNP is also of limited value compared with traditional risk factors for predicting significant CAD.

Footnotes

  • Funding: None.

  • Competing interests: None.

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