The Relationship Between N-terminal Pro-brain Natriuretic Peptide An D Severity Of Coronary Artery Disease And The Prognostic Value

Objectives: Discuss the relationship between N-terminal pro-brain natriuretic peptide and severity of coronary artery disease and the prognostic value.Methods: First, select 100 hospitalized patients who are receiving treatments of cardiovascular medicine in our hospital as the research objects and all the selected objects must take coronary angiography examinations after admission. The result shows that 79 patients have coronary heart disease(CHD) and 21 of them are stable angina pectoris(SAP group), 30 are unstable angina pectoris(UAP group), 28 are acute myocardial infarction pectoris(AMI group), the remaining 21 patients who have the normal angiography results is the control group. Later, divide the patients who have coronary heart disease into the first lesion group(n=19), the second lesion group(n=31) and the third lesion group(n=29) according to the results of coronary angiography examinations and obtain Gensini scores respectively. Test the instant N-terminal pro-brain natriuretic peptide(NT-pro BNP), creatine kinase isoenzyme(C K-MB) and Cardiac troponin I(c Tn I) of all the selected objects and analyze the relationship between the concentration change of NT-pro BNP、CK-MB、c Tn I in plasma and severity of coronary artery disease. Detect the plasma NT-pro BNP level of acute coronary syndrome(ACS) patients within 24 hours and after one week respectively, and observe the occurrence of major adverse cardiovascular events(MACE) during the follow-up period for one month.Results: 1. Compared with the plasma NT-pro BNP level of the control, SAP and UAP groups, the average plasma NT-pro BNP level of AMI group increases significantly, the plasma NT-pro BNP level of UAP group is significantly higher than SAP group and the control group, the plasma NT-pro BNP level of SAP group is higher than the control group and this difference is statistically significant. 2. There is a positive correlation between the plasma NT-pro BNP level and c Tn I level of AMI group, the correlation coefficient r=0.450 and this difference is statistically significant. 3. With the increase of severity of coronary artery disease, the plasma NT-pro BNP level of the third lesion group is significantly higher than the second lesion group and the plasma NT-pro BNP level of the second lesion group is significantly higher than the first lesion group, this difference is statistically significant(p<0.05). 4. There is a positive correlation between the plasma NT-pro BNP level and Gensini scores of the patients with coronary heart disease(CHD), the correlation coefficient r=0.962 and this difference is statistically significant(p<0.01). 5. Admission of the dead with acute coronary syndrome(ACS) and their plasma NT-pro BNP levels within 24 hours and after one week respectively are significantly higher than the survivors(p<0.01). 6. Based on the median value(281.50pg/ml) of plasma NT-pro BNP level within 24 hours of admission, the incidence of MACE of those acute coronary syndrome(ACS) pectoris who have higher plasma NT-pro BNP levels than median value is significantly higher than those acute coronary syndrome(ACS) pectoris who have lower plasma NT-pro BNP levels than median value during the follow-up period.Conclusions: 1. The plasma NT-pro BNP level of AMI group of coronary heart disease issignificantly higher than CTnl level and they are positively associated with each other. It prompts that the plasma NT-pro BNP level can be regarded as an indicator that points out the serious degree of myocardial infarction. 2. There is a positive correlation between the plasma NT-pro BNP level and the number of diseased coronary arteries as well as Gensini grades, and it prompts that the plasma NT-pro BNP level can reflect the degree of coronary artery lesions. 3. The plasma NT-pro BNP level can be regarded as an indicator that evaluates the illness degree and prognosis of the patients with coronary heart disease.