N-terminal pro-B-type natriuretic peptide predicts significant coronary artery lesion in the unstable angina patients with normal electrocardiogram, echocardiogram, and cardiac enzymes

Na Hong Seo, Sik Yoon Nam, Youngkeun Ahn, Sang Yeob Lim, Sook Kim Yong, Ho Yun Kyung, Koo Kang Dong, Hyun Lee Sang, Sang Lee Yeon, Hun Kim Kye, Seok Son Il, Joon Hong Young, Wook Park Hyung, Han Kim Ju, Ho Jeong Myung, Gwan Cho Jeong, Chun Park Jong, Chaee Kang Jung

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Abstract

Background: Brain natriuretic peptide (BNP) and N-terminal pro-brain natriuretic peptide (NT-proBNP) are not specific for ventricular dysfunction and other cardiac processes, such as myocardial ischemia, may also cause elevation of these markers. Methods and Results: To determine whether elevation of NT-proBNP without elevation of cardiac specific markers can predict coronary artery disease (CAD), the serum level of NT-proBNP was measured in 161 patients with unstable angina (61.0±8.1 years, male 54.0%) with normal ventricular function (left ventricular ejection fraction >55% and no regional wall motion abnormality by echocardiography) and normal troponin I level (<0.05 ng/ml). In these patients, levels of C-reactive protein and myoglobin were normal and none had Q wave on electrocardiographic (ECG). The NT-proBNP level was higher in patients with CAD (n=74) than in patients without CAD (n=87) (173.1±231.6 vs 68.1±62.5 pg/ml, p<0.001). At the standard cut-off point of >200 pg/ml, elevated NT-proBNP level shows high probability of CAD (odds ratio, 10.1; 95% confidence interval, 2.6-38.7, p=0.001). The NT-proBNP level positively correlated with the extent of CAD (r=0.329, p=0.001). In multivariate analysis, the NT-proBNP was an independent predictor of CAD. Conclusion: These results suggested that NT-proBNP is a useful screening test for CAD in the unstable angina patients with normal ECG, echocardiogram and cardiac enzyme levels.

Original languageEnglish
Pages (from-to)1472-1476
Number of pages5
JournalCirculation Journal
Volume69
Issue number12
DOIs
Publication statusPublished - 2005 Dec 1
Externally publishedYes

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Keywords

  • Coronary artery disease
  • NT-proBNP
  • Unstable angina

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Seo, N. H., Nam, S. Y., Ahn, Y., Lim, S. Y., Yong, S. K., Kyung, H. Y., Dong, K. K., Sang, H. L., Yeon, S. L., Kye, H. K., Il, S. S., Young, J. H., Hyung, W. P., Ju, H. K., Myung, H. J., Jeong, G. C., Jong, C. P., & Jung, C. K. (2005). N-terminal pro-B-type natriuretic peptide predicts significant coronary artery lesion in the unstable angina patients with normal electrocardiogram, echocardiogram, and cardiac enzymes. Circulation Journal, 69(12), 1472-1476. https://doi.org/10.1253/circj.69.1472