Role of B-type natriuretic peptide in diagnosis of coronary artery disease

Authors : Bedrettin BOYRAZ, Ferit Onur MUTLUER, Hakan ÇAKIR, Dursun TOPAL, Mehmet DEMİR, Fahri ER, Tezcan PEKER, Mustafa YILMAZ, Alkame AKGÜMÜŞ, Erhan TENEKECİOĞLU

Pages : 969-976

Doi:10.18621/eurj.447914

View : 34 | Download : 6

Publication Date : 2019-11-04

Article Type : Research Paper

Abstract :Objectives: B-type natriuretic peptide insert ignore into journalissuearticles values( BNP); has been extensively studied as a biomarker in heart failure. There is clear benefit of BNP in diagnosis and risk stratification of several cardiac diseases including acute coronary syndromes. Our aim was to evaluate diagnostic role of changes in BNP levels with exercise in coronary artery disease insert ignore into journalissuearticles values(CAD);. Methods: Fifty-one patients underwent exercise stress testing insert ignore into journalissuearticles values(EST); for suspected CAD and consequently underwent coronary angiography insert ignore into journalissuearticles values(CA); were prospectively enrolled. Patients with and without at least one significant diameter stenosis in major epicardial arteries insert ignore into journalissuearticles values(CA+ and CA-); versus patients with and without evidence of myocardial ischemia during exercise stress testing insert ignore into journalissuearticles values(EST+ and EST-); were classified into 4 groups, respectively insert ignore into journalissuearticles values(Group 1, CA+/EST+; group 2, CA+/EST-; group 3, CA-/EST+; and group 4, CA-/EST-);. All patients underwent EST. Blood was drawn from patients for determination of BNP levels 10 minutes prior to, 10 minutes after and 4 hours after EST. Results: EST parameters other than the parameters signifying myocardial ischemia didn’t differ significantly among groups insert ignore into journalissuearticles values( p > 0.05);. Pre-exercise, post-exercise and 4h-post exercise BNP values were significantly higher in group 1 and group 2 compared to group 3 and group 4 insert ignore into journalissuearticles values( p < 0.05 for all comparisons between the groups for pre-exercise, post-exercise and 4h-post exercise BNP);. Exercise-induced increases in BNP were higher in group 1 and group 2. Patients with significant CAD involving LAD demonstrated higher basal and exercise-induced BNP as well as BNP increases, irrespective of the EST result. Conclusions: Basal, maximal-exercise and post exercise BNP values predicted CAD, as well as CAD involving LAD irrespective of ischemic changes in EST. Our results point out potential role of BNP as an adjunct to EST in diagnosis and management of CAD. 
Keywords : Natriuretic peptide, coronary artery disease, exercise stress test, myocardial ischemia

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