NT-proANP and NT-proBNP circulating levels as predictors of cardiovascular outcome following coronary stent implantation
| Autor: | Francesco Burzotta, Giampaolo Niccoli, Simona Marchitti, Filippo Crea, Rocco Grippo, Carlo Trani, Francesco Fracassi, Antonio Maria Leone, Speranza Rubattu, Massimo Volpe, Sara Di Castro, Franca Bianchi, Micaela Conte, Marco Roberto, Rocco A. Montone |
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| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Time Factors medicine.medical_treatment Coronary Artery Disease Kaplan-Meier Estimate 030204 cardiovascular system & hematology Percutaneous coronary intervention Coronary artery disease 0302 clinical medicine Recurrence Risk Factors Natriuretic Peptide Brain 030212 general & internal medicine Myocardial infarction Non-ST Elevated Myocardial Infarction Aged 80 and over General Medicine Middle Aged Up-Regulation Treatment Outcome NT-proANP Cardiology Female Stents Cardiology and Cardiovascular Medicine Atrial Natriuretic Factor medicine.medical_specialty Acute coronary syndrome Disease-Free Survival 03 medical and health sciences Internal medicine Coronary stent medicine Humans Angina Stable cardiovascular diseases Aged Proportional Hazards Models Proportional hazards model business.industry medicine.disease Cardiovascular risk Peptide Fragments NT-proBNP Multivariate Analysis Conventional PCI Settore MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE business cardiovascular risk percutaneous coronary intervention cardiology and cardiovascular medicine Biomarkers Mace |
| Popis: | Background Natriuretic peptides are diagnostic/prognostic biomarkers in major cardiovascular diseases. We aimed at assessing the predictive role of N-terminal pro-A-type (NT-proANP) and pro-B-type (NT-proBNP) natriuretic peptides levels toward cardiovascular outcome in both stable and unstable coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in a non-primary PCI setting. Methods A total of 395 patients undergoing PCI with stent implantation for either stable angina (SA) or non ST-elevation acute coronary syndrome (NSTE-ACS) were enrolled. Pre-procedural NT-proANP and NT-proBNP levels were measured. Occurrence of major adverse cardiac events (MACEs), composite of cardiac death, non-fatal myocardial infarction, and clinically driven target lesion revascularization (c-TLR), was the endpoint of the study. Follow up mean time was 48.53±14.69months. Results MACEs occurred in forty-four patients (11%) during follow up. Both NT-proANP levels [3170 (2210–4630) vs 2283 (1314–3913) fmol/mL, p =0.004] and NT-proBNP levels [729 (356–1353) vs 511 (267–1006) fmol/mL, p =0.04] were significantly higher in patients with MACEs compared to patients without MACEs. Similar results were found when considering hard MACEs (myocardial infarction and cardiac death). NT-proANP levels were significantly higher in patients with c-TLR compared with patients without c-TLR [3705 (2766–5184) vs 2343 (1340–3960) fmol/mL, p =0.021]. At multivariate analysis, NT-proANP levels were a significant predictor of MACEs (HR 1.09, 95% CI 1.03–1.18, p =0.04). Kaplan–Meyer curves revealed that patients with elevated NT-proANP levels (>2.100fmol/mL) had a lower MACE free survival ( p =0.003). Conclusions Both NT-proANP and NT-proBNP levels were higher in CAD patients experiencing MACEs following PCI in a non-primary setting. Notably, only NT-proANP levels significantly affected prognosis after PCI. |
| Databáze: | OpenAIRE |
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