N-terminal B-type natriuretic peptide predicts extent of coronary artery disease and ischemia in patients with stable angina pectoris

Weber, Michael; Dill, Thorsten; Arnold, Román; Rau, Matthias; Ekinci, Okan; Müller, Klaus D.; Berkovitsch, Alexander; Mitrovic, Veselin; Hamm, Christian W.

doi:10.1016/j.ahj.2004.04.021

Cited by 143 publications

(107 citation statements)

References 16 publications

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“…All known factors that influence natriuretic peptide concentrations in the absence of HF (15)(16)(17). Furthermore, the 1-year mortality in our cohort of 28.0% was substantially higher than the 15.1% mortality reported from the Pro-BNP Investigation of Dyspnea in the Emergency Department (PRIDE) study, again suggesting that the population reported in this study was overall more "ill" than those of previously published studies (18 ).…”

Section: Discussioncontrasting

confidence: 54%

Impact of Renal Disease on Natriuretic Peptide Testing for Diagnosing Decompensated Heart Failure and Predicting Mortality

deFilippi

Seliger

Maynard³

et al. 2007

Clinical Chemistry

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Background: Concomitant occurrence of kidney disease (KD) and heart failure (HF) is common and associated with poor outcomes. Natriuretic peptide studies have typically excluded many individuals with KD. We compared the accuracy of B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) for diagnosing decompensated HF and predicting mortality across the spectrum of renal function. Methods: BNP and NT-proBNP were prospectively measured in a cohort of 831 dyspnea patients. KD was defined as an estimated glomerular filtration rate <60 mL ⅐ min ؊1 ⅐ (1.73 m 2 ) ؊1 . The accuracy and predictive value of each test for diagnosing decompensated HF and predicting all-cause 1-year mortality were assessed by ROC area under the curve (AUC) and multivariate regression analysis. Results: Among the 831 dyspnea patients, 393 (47%) had KD. The diagnostic accuracies of BNP and NT-proBNP in detecting decompensated HF were similar to each other in patients without KD (AUC 0.75 vs 0.74, respectively; P ‫؍‬ 0.60) and in patients with KD (AUC 0.68 vs 0.66; P ‫؍‬ 0.10). One-year mortality rates were 36.3% and 19.0% in those with and without KD, respectively (P <0.001). Progressively higher BNP and NT-proBNP concentrations remained predictive of increased mortality in KD patients. Compared with the lowest quartile, quartile 4 of BNP had an adjusted hazards ratio (HR) of 2.6 (95% CI 1.4 -4.8; P ‫؍‬ 0.004 for trend) and NT-proBNP

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Section: Discussioncontrasting

confidence: 54%

Impact of Renal Disease on Natriuretic Peptide Testing for Diagnosing Decompensated Heart Failure and Predicting Mortality

deFilippi

Seliger

Maynard³

et al. 2007

Clinical Chemistry

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“…19 p=0.827, respectively). However, the cTnI values 3 h after EST were substantially higher in the CAD group (0.854ng/ml±0.83 and 0.504ng/ ml±0.24 p=0.027, respectively).…”

Section: H-fabp Levels Before and After Est (Tables 3 4)mentioning

confidence: 99%

Relationship between heart-type fatty acid-binding protein levels and coronary artery disease in exercise stress testing: an observational study

Arı¹,

Tokaç²,

Alihanoğlu³

et al. 2011

Anadolu Kardiyol Derg

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Objective: Although, there has been great improvement on the diagnosis and early treatment of acute coronary syndromes, especially in terms of myocardial damage biochemical markers, we do not have a specific marker yet, for using the diagnosis of stable coronary artery disease (CAD). This study aimed to evaluate the relationship between CAD and the changes of heart-type fatty acid binding protein (H-FABP) levels before and after exercise stress testing (EST). Methods: A total of 47 patients were enrolled in this observational study. Of 47 patients, 21 had normal coronary anatomy; the remaining 26 patients had coronary lesions over 70% in at least one major coronary artery. All patients performed EST. Along with this, H-FABP levels before EST and at peak exercise, 1 st hour, 3 rd hour (3h), were measured in all patients. Differences among the measurements were evaluated through the Friedman test and Wilcoxon test, and the Bonferroni correction was applied to determine which measurement caused the difference. Results: Contrary to expectations, the means of the H-FABP values measured at particular intervals for each group tended to decline from the basal level to the 3h level. When the difference between the 3h measurement and the basal level was compared in each group, the decreasing was statistically significant in both groups (p<0.05). A statistically significant decrease at the 3h measurement compared to the basal level in the CAD group was more apparent than in the control group (2.790±2.569ng/ml vs. 0.837±2.070ng/ml, p=0.009). Conclusion: We found that H-FABP levels did not increase during EST and contrary to expectation, were inclined to decrease. We thought that decreasing H-FABP levels likely resulted from exercise-induced proteinuria. (Anadolu Kardiyol Derg 2011; 11: 685-91) Key words: Coronary artery disease, heart-type fatty acid binding protein, exercise stress testing 685 ÖZET Amaç: Akut koroner sendrom tanısı ve erken tedavisinde özellikle miyokardiyal hasar belirteçlerinde sağlanan ilerleme ile önemli bir mesafe alınmasına rağmen stabil koroner arter hastalığı (KAH) tanısında kullanılabilecek özel bir markır henüz yoktur. Bu çalışmada egzersiz stres testi (EST) öncesi ve sonrası H-FABP düzeylerindeki değişim ile koroner arter hastalığı arasındaki ilişki araştırılmıştır. Yöntemler: Gözlemsel çalışmamıza en az bir majör koroner arterinde %70 ve üzerinde darlığı olan 26 hasta ve koroner arterleri normal bulunan 21 hasta olmak üzere toplam 47 hasta alındı. Tüm hastalara EST yapıldı. Tüm hastalarda bazal, pik egzersiz, 1. saat ve 3. saatte H-FABP ölçümü yapıldı. Ölçümler arası farka Friedman Testi ile bakıldı, farkın hangi ölçümden kaynaklandığını bulmak için Bonferroni düzeltmeli Wilcoxon Testi kullanıldı. Bulgular: Her bir grupta belirlenen zaman aralığında ölçülen H-FABP değerleri ortalamaları beklenenin aksine bazaldan üçüncü saate azalma eğiliminde idi. Üçüncü saat ile bazal ölçümler arasındaki farklar (fark 3) grup içinde karşılaştırıldığında her iki grupta da azalma anlamlı idi (p<0.05). H...

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“…Currently, biochemical markers, such as C-reactive protein and natriuretic peptides, have been used as prognostic markers in CAD [2,3]. Signal averaged electrocardiogram (SAECG) is considered an important non-invasive indicator identifying patients at risk for ventricular arrhythmias and sudden death [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

SAECG in exercise test for prediction of diabetic coronary artery disease

Bigi

Aslani

2010

Open Medicine

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AbstractSignal averaged electrocardiogram (SAECG) is considered an important noninvasive indicator identifying patients at risk for ventricular arrhythmias. The aim of this study was to improve noninvasive prediction of CAD by integrating SAECG with the result of exercise tests in diabetic patients. Diabetic patients with stable angina pectoris underwent exercise testing and SAECG. Then a diagnostic score was derived that combined results of exercise testing and SAECG. A diagnostic score (0 to 2 points) was calculated by assigning 1 point for a positive exercise test result and 1 point for a positive SAECG. One hundred and seventy patients were included in the study. In patients with a score of 0, the likelihood of CAD is 18% whereas the likelihood of CAD is 95% in patients with a score of 2. Triple vessel CAD is present in 54%, 7% and only 1.5% of patients with score 2, 1 and 0 respectively. Therefore, patients with score 2 have a poor prognosis compared with score 1 or 0. A diagnostic score combining exercise testing and SAECG can distinguish patients with CAD from those without CAD with high accuracy in diabetic patients.

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N-terminal B-type natriuretic peptide predicts extent of coronary artery disease and ischemia in patients with stable angina pectoris

Cited by 143 publications

References 16 publications

Impact of Renal Disease on Natriuretic Peptide Testing for Diagnosing Decompensated Heart Failure and Predicting Mortality

Impact of Renal Disease on Natriuretic Peptide Testing for Diagnosing Decompensated Heart Failure and Predicting Mortality

Relationship between heart-type fatty acid-binding protein levels and coronary artery disease in exercise stress testing: an observational study

SAECG in exercise test for prediction of diabetic coronary artery disease

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