N末端脑钠肽前体在慢性稳定型心绞痛患者中的预后价值

Prognostic value of N-terminal pro-brain natriuretic peptide in patients with chronic stable angina.

作者信息

Ndrepepa Gjin, Braun Siegmund, Niemöller Kathrin, Mehilli Julinda, von Beckerath Nicolas, von Beckerath Olga, Vogt Wolfgang, Schömig Albert, Kastrati Adnan

机构信息

Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Germany.

出版信息

Circulation. 2005 Oct 4;112(14):2102-7. doi: 10.1161/CIRCULATIONAHA.105.550715. Epub 2005 Sep 26.

DOI:10.1161/CIRCULATIONAHA.105.550715

PMID:16186420

Abstract

BACKGROUND

Patients with chronic stable angina are poorly characterized in terms of biomarkers that help in the assessment of prognosis. We investigated whether plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) may be used as a prognostic marker in patients with chronic stable angina treated with coronary stenting.

METHODS AND RESULTS

Plasma levels of NT-proBNP were measured in 1059 patients with chronic stable angina and coronary angiographic confirmation of significant coronary artery disease. The primary end point of the study was mortality. After a median of 3.6 years (interquartile range, 3.3 to 4.5 years), there were 106 deaths. Kaplan-Meier estimates of 5-year mortality were 4.7% in the first quartile, 7.8% in the second quartile, 11.4% in the third quartile, and 32.7% in the fourth quartile of NT-proBNP (P<0.001). A Cox proportional hazards model showed that NT-proBNP was the strongest correlate of mortality (adjusted hazards ratio [HR], 5.83 [95% confidence interval: 2.07 to 16.44] for the fourth versus the first quartile). A similar prognostic value of NT-proBNP was demonstrated for cardiovascular mortality (HR, 5.98 [1.55 to 23.13] for the fourth versus the first quartile) and for patients with New York Heart Association class I and II (HR, 6.03 [2.07 to 17.52] for the fourth versus the first quartile).

CONCLUSIONS

Circulating levels of NT-proBNP are a strong prognostic biomarker for patients with chronic stable angina.

摘要

背景

在有助于评估预后的生物标志物方面，慢性稳定型心绞痛患者的特征尚不明确。我们研究了N末端脑钠肽前体（NT-proBNP）血浆水平是否可作为接受冠状动脉支架置入术治疗的慢性稳定型心绞痛患者的预后标志物。

方法与结果

对1059例慢性稳定型心绞痛且经冠状动脉造影证实存在显著冠状动脉疾病的患者测定了NT-proBNP血浆水平。该研究的主要终点是死亡率。中位随访3.6年（四分位间距为3.3至4.5年）后，有106例死亡。NT-proBNP第一四分位数组的5年死亡率经Kaplan-Meier估计为4.7%，第二四分位数组为7.8%，第三四分位数组为11.4%，第四四分位数组为32.7%（P<0.001）。Cox比例风险模型显示，NT-proBNP是死亡率最强的相关因素（第四四分位数组与第一四分位数组相比，校正风险比[HR]为5.83[95%置信区间：2.07至16.44]）。NT-proBNP对心血管死亡率（第四四分位数组与第一四分位数组相比，HR为5.98[1.55至23.13]）以及纽约心脏协会I级和II级患者（第四四分位数组与第一四分位数组相比，HR为6.03[2.07至17.52]）具有相似的预后价值。