Department of Cardiology, No. 101 Hospital of PLA, Wuxi, Jiangsu Province, China.
PLoS One. 2013 Dec 6;8(12):e82357. doi: 10.1371/journal.pone.0082357. eCollection 2013.
To evaluate the changes of plasma B-type natriuretic peptide(BNP) levels after high-pressure post-dilation following coronary stent deployment.
A total of 173 patients undergoing percutaneous coronary intervention for the left anterior descending artery were enrolled into the study. All patients were divided into two groups: the conventional group and the post-dilation group. The plasma BNP, troponin I(TnI), myocardial band isoenzyme of creatine kinase(CK-MB) levels and the serum high sensitive C-reactive protein(hs-CRP) levels immediately before and 24 hours after the interventional procedures were compared between the two groups.
There were no significant differences between the two groups in terms of clinical features, clinical and biochemical parameters, stent parameters, pre-procedural plasma BNP and TnI levels, pre-procedural serum hs-CRP levels, as well as pre- and post-procedural CK-MB levels (all P>0.05). In the conventional group, post-procedural plasma BNP levels were significantly reduced when compared with the pre-procedural levels, median(25th,75th) were 32.5 ng/L(15.0,52.4) vs. 37.7 ng/L(18.2,67.3), P = 0.001. In the post-dilation group, post-procedural plasma BNP levels were significantly increased when compared with the pre-procedural levels, median(25th,75th) were 53.5 ng/L(29.6,82.8) vs. 44.2 ng/L(17.15,70.7), P<0.0001. Post-procedural plasma TnI levels were also significantly increased when compared with the pre-procedural levels in both groups, median(25th,75th) were 0.02 ng/L(0.01,0.08) vs. 0.01 ng/L(0.01,0.01), 0.05 ng/L(0.01,0.35) vs. 0.01 ng/L(0.01,0.01), respectively, P<0.0001, so were the serum hs-CRP levels, median(25th,75th) were 3.3 mg/L(2.4,4.7) vs. 2.2 mg/L(1.4,3.3), 4.2 mg/L(3.175,5.825) vs. 2.3 mg/L(1.45,3.6), respectively, P<0.0001. Post-procedural plasma BNP, TnI and serum hs-CRP levels in the post-dilation group were significantly higher than those in the conventional group(all P<0.0001).
High-pressure post-dilation following coronary stent deployment resulted in a significant increase of plasma BNP levels, as well as plasma TnI levels and serum hs-CRP levels, which may be related to myocardial perfusion, more myocardial injury and more inflammation.
评估冠状动脉支架植入术后高压后扩张对血浆 B 型利钠肽（BNP）水平的变化。
共纳入 173 例行左前降支经皮冠状动脉介入治疗的患者。所有患者均分为常规组和后扩张组。比较两组患者介入治疗前后的血浆 BNP、肌钙蛋白 I（TnI）、肌酸激酶同工酶（CK-MB）水平和血清高敏 C 反应蛋白（hs-CRP）水平。
两组患者在临床特征、临床和生化参数、支架参数、术前血浆 BNP 和 TnI 水平、术前血清 hs-CRP 水平以及术前和术后 CK-MB 水平方面均无显著差异（均 P＞0.05）。常规组患者术后血浆 BNP 水平较术前明显降低，中位数（25％，75％）为 32.5ng/L（15.0，52.4）比 37.7ng/L（18.2，67.3），P=0.001。在后扩张组中，术后血浆 BNP 水平较术前明显升高，中位数（25％，75％）为 53.5ng/L（29.6，82.8）比 44.2ng/L（17.15，70.7），P＜0.0001。两组患者术后血浆 TnI 水平也较术前明显升高，中位数（25％，75％）分别为 0.02ng/L（0.01，0.08）比 0.01ng/L（0.01，0.01），0.05ng/L（0.01，0.35）比 0.01ng/L（0.01，0.01），P＜0.0001，血清 hs-CRP 水平也如此，中位数（25％，75％）分别为 3.3mg/L（2.4，4.7）比 2.2mg/L（1.4，3.3），4.2mg/L（3.175，5.825）比 2.3mg/L（1.45，3.6），P＜0.0001。后扩张组患者术后血浆 BNP、TnI 和血清 hs-CRP 水平均明显高于常规组（均 P＜0.0001）。
冠状动脉支架植入术后高压后扩张导致血浆 BNP 水平以及血浆 TnI 水平和血清 hs-CRP 水平显著升高，这可能与心肌灌注、更多的心肌损伤和更多的炎症有关。
