Correlation Of Coronary Artery Stenosis With Serum Levels Of N-Terminal Pro-Brain Natriuretic Peptide

Objective: To study the correlation of coronary artery stenosis with serum levels of N–terminal pro–brain natriuretic peptide (NT–proBNP) in the patients with coronary atherosclerotic heart disease.Method: 105 patients (male 63, female 42, aging 35 to 83, average 62±10.92) with coronary heart disease diagnosed by coronary arteriography were divided into stable angina pectoris (SAP) group, unstable angina pectoris (UAP) group and acute myocardial infarction (AMI) group. It was also divided into single, double and multi vessel coronary artery disease by the severity of coronary artery stenosis. We compared these groups with 32 age–and gender–matched cases who complained of chest pain and with negative CAG result (group 0). Blood samples for NT–proBNP were drawn from median vein of elbow in 24～48 hours after the next morning of admission to hospital. Among the these groups, the number of impaired coronary arteries, Gensini scores of coronary stenosis and NT–proBNP levels were compared respectively.Result: There was positive correlation between gensini scores and NT–proBNP in CHD patients(rs=0.416, P=0.000). Compared with the patients in UAP and AMI group, there were significant differences in Gensini scoring, serum levels of NT–proBNP in the patients of SAP group. Gensini scoring:SAP23.94±26.29 vs UAP50.57±30.94(P=0.000); SAP23.94±26.29 vs AMI 76.22±27.73(P=0.000); NT–proBNP:normal group2.39±0.20 vs SAP group 2.60±0.28(P=0.000), SAP group2.60±0.28 vs UAP group 2.85±0.24(P=0.000), SAP group 2.60±0.28 vs AMI group 2.96±0.30(P=0.000). There was significant difference in Gensini scoring between the UAP and AMI group(50.57±30.94vs76.22±27.73,P=0.003),but not in NT–proBNP levels(2.85±0.24vs2.96±0.30 P=0.053). Gensini scores and NT–proBNP levels in CHD group were higher than normal group and it showed statistic difference in multi vessel disease group compared with single vessel, double vessel disease and normal group. Gensini scores:single vessel 29.03±25.01 vs double vessel 54.03±32.97, P=0.001; single vessel 29.03±25.01vs multi vessel 71.33±33.46, P=0.000; double vessel 54.03±32.97 vs multi vessel 71.33±33.46, P=0.036. NT–proBNP: normal group 2.39±0.20 vs single vessel 2.66±0.28, P=0.000; single vessel 2.66±0.28 vs double vessel 2.80±0.30, P=0.04; single vessel 2.66±0.28vs multi vessel 2.96±0.29, P=0.000; double vessel 2.80±0.30 vs multi vessel 2.96±0.29, P=0.033. An increase in hypertension, total cholesterol, and low density lipoprotein (LDL), was observed in the coronary artery disease (CHD) groups compared with the normal group。Hypertension:normal group 28.1%, SAP group 56.3%, UAP group 78.4%, AMI group 44.4%;TC:normal group 4.40±1.06mmol/L, SAP group 4.79±0.08mmol/L, UAP group 4.51±1.15mmol/L, AMI group 4.92±0.63mmol/L; LDL : normal group 2.42±0.81 mmol/L, SAP group 2.75±0.95 mmol/L, UAP group 2.74±0.94 mmol/L, AMI group 3.05±0.58 mmol/L. Compared with the normal and multi vessel disease group, there just show statistic significance in blood pressure and LDL(63.9%vs28.1%,P<0.05; 2.94±0.91vs2.42±0.81mmol/L,P<0.05). There is no statistic significance in cardiac function among single vessel, double vessel, multi vessel, SAP group, UAP group, P>0.05.Conclusion: Serum levels of NT–proBNP elevate in patients with coronary atherosclerotic heart disease (CHD), and correlates with coronary artery stenosis in patients with coronary heart disease. Elevated NT–proBNP levels can estimate the severity of involved coronary vessels and reflect the severity of myocardial necrosis. Serum levels of NT–proBNP can evaluate the risk of CHD. The risk factors for CHD, such as hypertension and high levels of LDL and so on, are associated with severity of CHD and severity of coronary artery stenosis.