NT-proBNP, Hs-CRP And Echocardiography: Diagnostic Value For ACS And Predictive Value For The Degree Of Coronary Artery Lesion

Objective： To investigate the value of NT-proBNP, hs-CRP level andechocardiography in early diagnosis of coronary syndrome (ACS) andprediction of coronary artery lesion degree.Methods： Continuously enrolled142patients admitted in our hospital forchest pain from March2013to February2014, collected their history, allpatients’ plasma levels of N-terminal pro-Brain Natriuretic Peptide(NT-proBNP), hypersensitive C-reative protein (hs-CRP) and cardiactroponin t (cTnT) were tested within24hours, electrocardiogram (ECG)were tested, left ventricular ejection fraction (LVEF) and left ventricularend-diastolic diameter (LVEDd) were recorded by echocardiography,coronary angiography were conducted during hospitalization, according tothe history and test results, patients were divided into acute ST segmentelevation myocardial infarction (STEMI) group, acute non-ST segmentelevation myocardial infarction (NSTEMI) group, unstable angina pectoris (UA) group and control group (normal coronary angiography, cTnT andECG). Patients with abnormal coronary angiography results were furtherdivided into single vessel lesion group, double vessel lesion group andtriple vessel lesion group. We compared of the plasma NT-proBNP level,hs-CRP level and LVEF in each group, conducted multivariate linearregression analysis to find out the independent risk factors for elevatedplasma NT-proBNP.Results：102ACS patients (32in STEMI group,30in NSTEMI group,40in UA group) and40normal patients (control group) were enrolled. Plasmalevels of NT-proBNP, hs-CRP and LVEF in acute myocardial infarction(AMI) patients (include NSTEMI group and STEMI group) weresignificant different from UA group and control group respectively(P<0.05). The NT-proBNP levels in control group and triple vessel lesiongroup (n=41) were respectively significant different from both single vessellesion group (n=30) and double vessel lesion group (n=31)(P<0.05).Multivariate linear regression analysis showed that, elevated plasmaNT-proBNP level was independently associated with hs-CRP level(P=0.007), coronary artery lesion degree (P=0.001), history of diabetes(P=0.006) and LVEF (P=0.036).Conclusions： Plasma NT-proBNP level, hs-CRP level and LVEF areclosely related to ACS, they might play an important role in early diagnosisand clinical classification. Plasma NT-proBNP level can be an important molecular marker to reflect the degree of coronary artery lesion.