Ribeiro Demóstenes G L, Silva Ricardo P, Barboza Daniella R M M, Lima-Júnior Roberto C P, Ribeiro Ronaldo A
Department of Clinical Medicine, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Ceará, Fortaleza, CE, Brazil.
Clinics (Sao Paulo). 2014 Jun;69(6):405-12. doi: 10.6061/clinics/2014(06)07.
This study aimed to investigate the clinical correlation between angiographic coronary atherosclerosis and N-terminal pro-B-type natriuretic peptide along with other known correlated factors.
In total, 153 patients with a diagnostic hypothesis of stable angina, unstable angina or acute myocardial infarction were classified as group A (patients with angiographically normal coronary arteries) or group B (patients with angiographic coronary atherosclerosis). The two groups were analyzed with respect to the following factors: gender, age, body mass index, abdominal circumference, smoking, diabetes mellitus, arterial hypertension, early family history of atherosclerosis, statin use, the presence of metabolic syndrome, clinical presentation and biochemical factors, including cholesterol, creatinine and fibrinogen plasma concentrations, monocyte counts and N-terminal pro-B-type natriuretic peptide.
Univariate analyses comparing the two groups revealed that group B patients more frequently had diabetes, used statins and had systolic dysfunction, N-terminal pro-B-type natriuretic peptide levels ≥ 250 pg/mL, fibrinogen levels >500 mg/dL and ≥ 501 monocytes/mm3 compared with group A patients (p<0.05). Nevertheless, multivariate logistic regression analysis demonstrated that the independent predictors of angiographic coronary atherosclerosis were an N-terminal pro-B-type natriuretic peptide level ≥ 250 pg/mL, diabetes mellitus and increased monocyte numbers and fibrinogen plasma concentration, regardless of the creatinine level or the presence of systolic dysfunction.
An N-terminal pro-B-type natriuretic peptide plasma concentration of ≥ 250 pg/mL is an independent predictor of angiographic coronary atherosclerosis.
本研究旨在探讨冠状动脉造影显示的动脉粥样硬化与N端前脑钠肽以及其他已知相关因素之间的临床相关性。
总共153例诊断为稳定型心绞痛、不稳定型心绞痛或急性心肌梗死的患者被分为A组（冠状动脉造影显示冠状动脉正常的患者）和B组（冠状动脉造影显示有冠状动脉粥样硬化的患者）。对两组患者的以下因素进行分析：性别、年龄、体重指数、腹围、吸烟、糖尿病、动脉高血压、动脉粥样硬化家族史、他汀类药物使用情况、代谢综合征的存在情况、临床表现以及生化因素，包括胆固醇、肌酐和血浆纤维蛋白原浓度、单核细胞计数和N端前脑钠肽。
两组的单因素分析显示，与A组患者相比，B组患者更常患有糖尿病、使用他汀类药物，并且有收缩功能障碍、N端前脑钠肽水平≥250 pg/mL、纤维蛋白原水平>500 mg/dL以及≥501个单核细胞/mm³（p<0.05）。然而，多因素逻辑回归分析表明，冠状动脉造影显示的动脉粥样硬化的独立预测因素是N端前脑钠肽水平≥250 pg/mL、糖尿病、单核细胞数量增加以及血浆纤维蛋白原浓度升高，而与肌酐水平或收缩功能障碍的存在无关。
血浆N端前脑钠肽浓度≥250 pg/mL是冠状动脉造影显示的动脉粥样硬化的独立预测因素。
