Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease

Dao-Fu Dai; Juey-Jen Hwang; Jiunn-Lee Lin; Jou-Wei Lin; Chih-Neng Hsu; Chih-Min Lin; Fu-Tien Chiang; Ling-Ping Lai; Kwan-Lih Hsu; Chuen-Den Tseng; Yung-Zu Tseng

doi:10.1253/circj.72.1316

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Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease

Journal article

Open access

Peer reviewed

Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease

Dao-Fu Dai, Juey-Jen Hwang, Jiunn-Lee Lin, Jou-Wei Lin, Chih-Neng Hsu, Chih-Min Lin, Fu-Tien Chiang, Ling-Ping Lai, Kwan-Lih Hsu, Chuen-Den Tseng, …

Circulation journal : official journal of the Japanese Circulation Society, Vol.72(8), pp.1316-1323

08/2008

DOI: 10.1253/circj.72.1316

PMID: 18654020

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Abstract

This study was designed to evaluate the joint effects of plasma C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) vs coronary angiographic severity on cardiovascular risk stratification. A total of 345 patients with stable coronary artery disease (CAD) were recruited after successful percutaneous coronary intervention (PCI). Endpoints were major adverse cardiovascular events (MACE) and cumulative clinical restenosis rate after 18-36-month follow-up. Plasma NT-proBNP and CRP levels were among the strongest predictors of MACE. Adjusted hazard ratios of MACE according to combined biomarkers were 2.4 (p=0.05) for elevated CRP only, 5.22 (p<0.001) for elevated NT-proBNP only, and 7.04 (p<0.001) for elevation of both. The differential capacity using both plasma CRP and NT-proBNP in a receiver-operating-characteristics curve analysis (area under curve, AUC: 0.82) was significantly higher than using either biomarker alone or conventional risk factors (AUC: 0.67). Significant predictors of clinical restenosis were plasma NT-proBNP and the Gensini score. The combination of NT-proBNP and the Gensini score was the strongest predictor (AUC: 0.77) for clinical restenosis. Plasma NT-proBNP, CRP, and the Gensini score are complementary in risk stratification. Combined use of these biomarkers has provided substantial extra information to conventional risk factors in stable CAD patients.

Predictive Value of Tests

Prospective Studies

Humans

Middle Aged

Male

Angioplasty, Balloon, Coronary - adverse effects

Coronary Restenosis - diagnosis

C-Reactive Protein - metabolism

Time Factors

Cardiovascular Diseases - diagnostic imaging

Peptide Fragments - blood

Female

Natriuretic Peptide, Brain - blood

Cardiovascular Diseases - diagnosis

Coronary Restenosis - etiology

Severity of Illness Index

Cardiovascular Diseases - etiology

Cardiovascular Diseases - metabolism

Risk Assessment

Coronary Artery Disease - metabolism

Risk Factors

Biomarkers - blood

Coronary Restenosis - diagnostic imaging

Coronary Restenosis - metabolism

Coronary Angiography

Disease-Free Survival

Coronary Artery Disease - diagnostic imaging

Coronary Artery Disease - therapy

ROC Curve

Aged

Details

Title: Subtitle: Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease
Creators: Dao-Fu Dai - Cardiovascular Division, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
Juey-Jen Hwang
Jiunn-Lee Lin
Jou-Wei Lin
Chih-Neng Hsu
Chih-Min Lin
Fu-Tien Chiang
Ling-Ping Lai
Kwan-Lih Hsu
Chuen-Den Tseng
Yung-Zu Tseng
Resource Type: Journal article
Publication Details: Circulation journal : official journal of the Japanese Circulation Society, Vol.72(8), pp.1316-1323
Publisher: Japan
DOI: 10.1253/circj.72.1316
PMID: 18654020
ISSN: 1346-9843
eISSN: 1347-4820
Language: English
Date published: 08/2008
Academic Unit: Pathology; Iowa Neuroscience Institute; Radiation Oncology
Record Identifier: 9984047771802771

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