Value of serum N-terminal pro-B-type natriuretic peptide for the diagnosis and prognosis evaluation in patients with coronary heart disease

Objective To study the diagnosis and prognosis significance of serum N-terminal pro-B-type natriuretic peptide(NT-proBNP)levels in patients with coronary heart disease(CHD).Methods 132 patients with CHD were classified into the symptomless group,stable angina pectoris(SAP)group,unstable angina pectoris(UAP)group and acute myocardial infarction(AMI)group according to the severe degree of CHD.30 healthy controls were enrolled,and 34 patients with acute coronary syndrome(ACS)were hospitalized and detected on the 7th d,15th d and 30th d.Their serum NT-proBNP and cardiac troponin I(cTnI) levels were measured by bi-directional lateral flow immunoassay.The patients with CHD were synchronously examined by electrocardiogram.The main adverse cardiovascular events(MACE) were followed up for 180 d.Results The serum NT-proBNP levels in patients with various CHD were significantly higher than those in the healthy controls(P0.01).The degree of CHD was more severe with the increasing level of serum NT-proBNP.The serum NT-proBNP level was positively correlated with New York Heart Association(NYHA) Ⅰ-Ⅳ(r=0.81,P0.01).The cases of MACE with NYHA Ⅲ-Ⅳ and ST-T changes during the follow-up period in CHD patients with NT-proBNP1 596.63 ng/L were significantly higher than those with NT-proBNP≤1 596.63 ng/L(P0.01).The serum NT-proBNP levels in improved ACS patients on the 7th d after treatment decreased significantly(P0.01),and the level decreased gradually in follow-up period.The serum NT-proBNP levels of the death group on the 15th d after treatment were significantly higher than those before treatment,and the level gradually increased in the course of treatment(P0.01).The serum NT-proBNP levels of the worsening heart failure(HF) group before and after the treatment had no significant difference(P0.05).The serum NT-proBNP levels of death group with negative cTnI and death group with positive cTnI were not significantly different(P0.05).Conclusions The levels of serum NT-proBNP are closely correlated with the severity of CHD,which have an important clinical value in the early diagnosis,prognosis and death risk evaluation.NT-proBNP can be used as a monitoring indicator of CHD risk stratification.