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N 末端脑利钠肽前体与左心室射血分数保留的不稳定型心绞痛患者冠状动脉病变严重程度相关。

N-terminal pro-B-type natriuretic peptide is associated with severity of the coronary lesions in unstable angina patients with preserved left ventricular function.

机构信息

Department of Cardiology, Hangzhou No. 1 Municipal Hospital and Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China.

出版信息

J Interv Cardiol. 2012 Apr;25(2):126-31. doi: 10.1111/j.1540-8183.2011.00697.x. Epub 2011 Dec 12.

Abstract

OBJECTIVES

To evaluate the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) values and the severity of coronary lesions at angiography in unstable angina patients with preserved left ventricular function.

METHODS

A total of 133 patients with primary diagnosis of unstable angina were enrolled into this study. NT-proBNP level was determined before the angiography and Gensini score, a measurement of extent of myocardial ischemia, was calculated after the angiography by experienced cardiologists. Patients with >50% stenosis of the left main or 75% stenosis of one or more coronary branches with diameter >2 mm were defined as "angiography positive" and turned to percutaneous coronary intervention.

RESULTS

There was a significant difference of circulating NT-proBNP level between the angiography positive and negative groups and the median NT-proBNP values were 367.5 pg/mL and 112 pg/mL, respectively (P < 0.001). A significant correlation was observed between log NT-proBNP and log Gensini score (P < 0.001). NT-proBNP level was a predictor of angiography positive result and the area under the receiver operating characteristic curve was 0.776 (95% CI 0.693-0.858).

CONCLUSIONS

NT-proBNP level was found to be higher with the severity of myocardial ischemia. However, the ability of NT-proBNP to identify clinically significant angiographic lesions was moderate.

摘要

目的

评估左心室功能正常的不稳定型心绞痛患者中,N 末端脑利钠肽前体(NT-proBNP)值与冠状动脉造影严重程度的相关性。

方法

本研究共纳入 133 例初诊为不稳定型心绞痛的患者。在进行冠状动脉造影之前测定 NT-proBNP 水平,由有经验的心脏病专家在冠状动脉造影后计算 Gensini 评分,该评分是心肌缺血程度的测量指标。左主干狭窄>50%或直径>2mm 的一条或多条冠状动脉狭窄>75%的患者被定义为“造影阳性”,并转为经皮冠状动脉介入治疗。

结果

在造影阳性和阴性组之间,循环 NT-proBNP 水平存在显著差异,中位数 NT-proBNP 值分别为 367.5pg/ml 和 112pg/ml(P<0.001)。log NT-proBNP 与 log Gensini 评分之间存在显著相关性(P<0.001)。NT-proBNP 水平是造影阳性结果的预测指标,受试者工作特征曲线下面积为 0.776(95%CI 0.693-0.858)。

结论

随着心肌缺血程度的加重,NT-proBNP 水平升高。然而,NT-proBNP 识别有临床意义的血管造影病变的能力中等。

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