Department of Surgery, University of Toronto, Toronto, ON, Canada.
Division of Vascular Surgery, St. Michael's Hospital, Toronto, ON, Canada.
PLoS One. 2021 Jul 21;16(7):e0253792. doi: 10.1371/journal.pone.0253792. eCollection 2021.
N-terminal pro B-type natriuretic peptide (NT-proBNP), a cardiac disease biomarker, has been demonstrated to be a strong independent predictor of cardiovascular events in patients without heart failure. Patients with peripheral arterial disease (PAD) are at high risk of cardiovascular events and death. In this study, we investigated levels of NT-proBNP in patients with PAD compared to non-PAD controls. A total of 355 patients were recruited from outpatient clinics at a tertiary care hospital network. Plasma NT-proBNP levels were quantified using protein multiplex. There were 279 patients with both clinical and diagnostic features of PAD and 76 control patients without PAD (non-PAD cohort). Compared with non-PAD patients, median (IQR) NT-proBNP levels in PAD patients were significantly higher (225 ng/L (120-363) vs 285 ng/L (188-425), p- value = 0.001, respectively). Regression analysis demonstrated that NT-proBNP remained significantly higher in patients with PAD relative to non-PAD despite adjusting for age, sex, hypercholesterolemia, smoking and hypertension [odds ratio = 1.28 (1.07-1.54), p-value <0.05]. Subgroup analysis showed elevated NT-proBNP levels in patients with PAD regardless of prior history of CHF, CAD, diabetes and hypercholesteremia (p-value <0.05). Finally, spearmen's correlation analysis demonstrated a negative correlation between NT-proBNP and ABI (ρ = -0.242; p-value < 0.001). In conclusion, our data shows that patients with PAD in an ambulatory care setting have elevated levels of NT-proBNP compared to non-PAD patients in the absence of cardiac symptoms.
N 末端脑利钠肽前体（NT-proBNP）是一种心脏疾病生物标志物，已被证明是心力衰竭患者心血管事件的强有力独立预测因子。外周动脉疾病（PAD）患者发生心血管事件和死亡的风险较高。在这项研究中，我们比较了 PAD 患者与非 PAD 对照组之间的 NT-proBNP 水平。共从一家三级护理医院网络的门诊诊所招募了 355 名患者。使用蛋白多重分析定量检测血浆 NT-proBNP 水平。其中 279 名患者既有 PAD 的临床和诊断特征，76 名患者无 PAD（非 PAD 队列）。与非 PAD 患者相比，PAD 患者的 NT-proBNP 中位数（IQR）水平明显更高（225ng/L（120-363）比 285ng/L（188-425），p 值=0.001）。回归分析表明，即使在调整年龄、性别、高胆固醇血症、吸烟和高血压后，PAD 患者的 NT-proBNP 仍然明显高于非 PAD 患者[比值比=1.28（1.07-1.54），p 值<0.05]。亚组分析显示，无论既往是否存在心力衰竭、冠心病、糖尿病和高胆固醇血症，PAD 患者的 NT-proBNP 水平均升高（p 值<0.05）。最后，Spearman 相关分析表明 NT-proBNP 与 ABI 呈负相关（ρ=-0.242；p 值<0.001）。总之，我们的数据表明，在门诊环境中，与无心脏症状的非 PAD 患者相比，PAD 患者的 NT-proBNP 水平升高。
