Relationship Between Changes Of Plasma B-type Natriuretic Peptide And Severity Of Coronary Artery Disease

Objective: To investigate the relationship between the changes of venous plasma B-type natriuretic peptide(BNP)and the severity of coronary artery disease.Methods:A total of 118 patients with suspected coronary heart disease were included from July 2019 to December 2019 in the fifth intracardiac department of the second Hospital of Hebei Medical University.After admission,coronary angiography(CAG)was performed to collect clinical baseline data and CAG results.?BNP was taken at rest in the morning after admission(baseline BNP),if angina attacks occurred in hospital,venous plasma BNP was extracted immediately.If angina pectoris did not occur before coronary angiography,6-minute walking test was performed to induce myocardial ischemia.Plasma BNP was extracted 2minute after exercise,△ BNP is the difference between load BNP and baseline BNP.According to the results of coronary angiography,patients with suspected coronary heart disease were divided into non-coronary artery stenosis group and coronary heart disease group.?According to the number of diseased vessels,the coronary heart disease group was divided into different subgroups,single-vessel disease group,two-vessel disease group and multi-vessel disease group.?The relationship between the changes of plasma BNP and the severity of coronary artery disease was compared.The statistical results were processed by SPSS22.0 statistical software.Results:1.After myocardial ischemia in two-vessel disease group and multi-vessel disease group,the load BNP level increased significantly compared with baseline.BNP increased in two-vessel disease group(67.9±33.8 vs 98.6±47.5pg/ml,P=0.000)and multi-vessel disease group(80.7±54.8 vs 145.2±73.1pg/ml,P=0.000).The difference was statistically.However,load BNP level of non-coronary artery stenosis group and single vessel disease group was not significantly increased than baseline(all P > 0.05),there was no significant difference.2.The more severe the coronary artery disease,the higher the plasma △BNP(1.9±10.9 vs 8.1±22.9 vs 30.7±23.1 vs 64.5±29.9pg/ml,P=0.003),Significant difference in the level of △BNP between groups.3.In patients with coronary artery disease,the elevated level of plasma BNP was positively correlated with the Gensini score of the degree of coronary artery stenosis(r = 0.718,P<0.05).?4.△BNP is related to the degree of coronary artery disease.Using the ROC curve,when the cutoff value is △BNP=39.95pg/ml,the area under the curve is 0.878(95% CI:0.798 ~ 0.958,P<0.05).It is possible to predict multi-vessel lesions of coronary artery disease.The sensitivity was 89.5%,the specificity was 74.2%,and the score Youden index was 0.637.Conclusion: The change level of BNP before and after exercise can reflect the severity of coronary artery disease in patients with coronary heart disease to some extent,and has a certain predictive value for multi-vessel disease.