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Abubakar M, Irfan U, Abdelkhalek A, Javed I, Khokhar MI, Shakil F, Raza S, Salim SS, Altaf MM, Habib R, Ahmed S, Ahmed F. Comprehensive Quality Analysis of Conventional and Novel Biomarkers in Diagnosing and Predicting Prognosis of Coronary Artery Disease, Acute Coronary Syndrome, and Heart Failure, a Comprehensive Literature Review. J Cardiovasc Transl Res 2024:10.1007/s12265-024-10540-8. [PMID: 38995611 DOI: 10.1007/s12265-024-10540-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 06/25/2024] [Indexed: 07/13/2024]
Abstract
Coronary artery disease (CAD), acute coronary syndrome (ACS), and heart failure (HF) are major global health issues with high morbidity and mortality rates. Biomarkers like cardiac troponins (cTn) and natriuretic peptides (NPs) are crucial tools in cardiology, but numerous new biomarkers have emerged, proving increasingly valuable in CAD/ACS. These biomarkers are classified based on their mechanisms, such as fibrosis, metabolism, inflammation, and congestion. The integration of established and emerging biomarkers into clinical practice is an ongoing process, and recognizing their strengths and limitations is crucial for their accurate interpretation, incorporation into clinical settings, and improved management of CVD patients. We explored established biomarkers like cTn, NPs, and CRP, alongside newer biomarkers such as Apo-A1, IL-17E, IgA, Gal-3, sST2, GDF-15, MPO, H-FABP, Lp-PLA2, and ncRNAs; provided evidence of their utility in CAD/ACS diagnosis and prognosis; and empowered clinicians to confidently integrate these biomarkers into clinical practice based on solid evidence.
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Affiliation(s)
- Muhammad Abubakar
- Department of Internal Medicine, Ameer-Ud-Din Medical College, 6 Birdwood Road, Jinnah Town, Lahore, 54000, Punjab, Pakistan.
| | - Umema Irfan
- Department of Internal Medicine, Deccan College of Medical Sciences, Hyderabad, India
| | - Ahmad Abdelkhalek
- Department of Internal Medicine, Zhejiang University, Zhejiang, China
| | - Izzah Javed
- Department of Internal Medicine, Ameer-Ud-Din Medical College, 6 Birdwood Road, Jinnah Town, Lahore, 54000, Punjab, Pakistan
| | | | - Fraz Shakil
- Department of Emergency Medicine, Mayo Hospital, Lahore, Pakistan
| | - Saud Raza
- Department of Anesthesia, Social Security Teaching Hospital, Lahore, Punjab, Pakistan
| | - Siffat Saima Salim
- Department of Surgery, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh
| | - Muhammad Mahran Altaf
- Department of Internal Medicine, Ameer-Ud-Din Medical College, 6 Birdwood Road, Jinnah Town, Lahore, 54000, Punjab, Pakistan
| | - Rizwan Habib
- Department of Internal Medicine and Emergency, Indus Hospital, Lahore, Pakistan
| | - Simra Ahmed
- Department of Internal Medicine, Ziauddin Medical College, Karachi, Pakistan
| | - Farea Ahmed
- Department of Internal Medicine, Ziauddin Medical College, Karachi, Pakistan
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Chen M, Li P, Huang Y, Li S, Ruan Z, Qin C, Huang J, Wang R, Lin Z, Liu P, Xu L. Development and validation of a nomogram for predicting significant coronary artery stenosis in suspected non-ST-segment elevation acute coronary artery syndrome with low-to-intermediate risk stratification. Front Cardiovasc Med 2022; 9:1013563. [PMID: 36601070 PMCID: PMC9807079 DOI: 10.3389/fcvm.2022.1013563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022] Open
Abstract
Background Patients with non-ST-segment coronary artery syndrome (NSTE-ACS) have significant heterogeneity in their coronary arteries. A better assessment of significant coronary artery stenosis (SCAS) in low-to-intermediate risk NSTE-ACS patients would help identify who might benefit from invasive coronary angiography (ICA). Our study aimed to develop a multivariable-based model for pretesting SCAS in suspected NSTE-ACS with low-to-intermediate risk. Methods This prediction nomogram was constructed retrospectively in 469 suspected NSTE-ACS patients with low-to-intermediate risk. Patients were divided into a development group (n = 331, patients admitted to hospital before 1 May 2021) and a temporal validation group (n = 138, patients admitted to hospital since 1 May 2021). The outcome was existing SCAS, including left main artery stenosis ≥50% or any subepicardial coronary artery stenosis ≥70%, all confirmed by invasive coronary angiography. Pretest predictors were selected using Least Absolute Shrinkage and Selection Operator (LASSO) and stepwise logistic regression. Results Derivation analyses from the development group (n = 331, admitted before 1 May 2021) generated the 7 strongest predictors out of 25 candidate variables comprising smoker, diabetes, heart rate, cardiac troponin T, N-terminal pro-B-type natriuretic peptide, high-density lipoprotein cholesterol, and left atrial diameter. This nomogram model showed excellent discrimination ability with an area under the receiver operating characteristic curve (AUC) of 0.83 in the development set and 0.79 in the validation dataset. Good calibration was generally displayed, although it slightly overestimated patients' SCAS risk in the validation group. Decision curve analysis demonstrated the clinical benefit of this model, indicating its value in clinical practice. Furthermore, an optimal cut-off of prediction probability was assigned as 0.61 according to the Youden index. Conclusion A prediction nomogram consisting of seven readily available clinical parameters was established to pretest the probability of SCAS in suspected NSTE-ACS patients with low-to-intermediate risk, which may serve as a cost-effective risk stratification tool and thus assist in initial decision making.
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Affiliation(s)
- Meixiang Chen
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Pengfei Li
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Yuekang Huang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Shuang Li
- General Hospital of the Southern Theatre Command, Chinese People’s Liberation Army (PLA), Guangzhou, Guangdong, China
| | - Zheng Ruan
- General Hospital of the Southern Theatre Command, Chinese People’s Liberation Army (PLA), Guangzhou, Guangdong, China
| | - Changyu Qin
- The First School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China
| | - Jianyu Huang
- General Hospital of the Southern Theatre Command, Chinese People’s Liberation Army (PLA), Guangzhou, Guangdong, China
| | - Ruixin Wang
- General Hospital of the Southern Theatre Command, Chinese People’s Liberation Army (PLA), Guangzhou, Guangdong, China
| | - Zhongqiu Lin
- General Hospital of the Southern Theatre Command, Chinese People’s Liberation Army (PLA), Guangzhou, Guangdong, China
| | - Peng Liu
- Zhujiang Hospital, The Second School of Clinical Medicine, Southern Medical University, Guangzhou, Guangdong, China,Peng Liu,
| | - Lin Xu
- General Hospital of the Southern Theatre Command, Chinese People’s Liberation Army (PLA), Guangzhou, Guangdong, China,Branch of National Clinical Research Center for Geriatric Diseases, Chinese PLA General Hospital, Guangzhou, Guangdong, China,*Correspondence: Lin Xu,
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Muzafarova T, Motovska Z. Laboratory Predictors of Prognosis in Cardiogenic Shock Complicating Acute Myocardial Infarction. Biomedicines 2022; 10:biomedicines10061328. [PMID: 35740350 PMCID: PMC9220203 DOI: 10.3390/biomedicines10061328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 05/29/2022] [Accepted: 06/01/2022] [Indexed: 12/02/2022] Open
Abstract
Cardiogenic shock is a state of reduced cardiac output leading to hypotension, pulmonary congestion, and hypoperfusion of tissues and vital organs. Despite the advances in intensive care over the last years, the morbidity and mortality of patients remain high. The available studies of patients with cardiogenic shock suggest a connection between clinical variables, the level of biomarkers, the results of imaging investigations, strategies of management and the outcome of this group of patients. The management of patients with cardiogenic shock initially complicating acute myocardial infarction is challenging, and the number of studies in this area is growing fast. The purpose of this review is to summarize the currently available evidence on cardiogenic shock initially complicating acute myocardial infarction with particular attention to predictors of prognosis, focusing on laboratory variables (established and new), and to discuss the practical implementation. Currently available scoring systems developed during the past few decades predict the clinical outcome of this group of patients using some of the established biomarkers among other variables. With the new laboratory biomarkers that have shown their predictive value in cardiogenic shock outcomes, a new design of scoring systems would be of interest. Identifying high-risk patients offers the opportunity for early decision-making.
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Del Buono MG, Trankle CR, Buckley L, Kadariya D, Canada JM, Carbone S, Turlington J, Markley R, Bressi E, VAN Tassell BW, Abbate A. Early changes in N-terminal pro-brain natriuretic peptide levels predict new-onset heart failure in patients with STEMI. Minerva Cardiol Angiol 2022; 70:25-31. [PMID: 32657561 DOI: 10.23736/s2724-5683.20.05303-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Previous studies suggested that N-terminal pro-brain natriuretic peptide (NT-proBNP) level is a powerful independent predictor of death or heart failure (HF) when measured at admission in patients with chest pain or acute coronary syndrome. Little is known about the role of NT-proBNP level measured during a hospitalization for ST segment elevation myocardial infarction (STEMI) in predicting clinical outcomes. We evaluated the optimal NT-proBNP timing (admission, 72 hours, or delta [Δ] NT-proBNP [72 hours minus admission]) to predict 1-year new-onset HF in STEMI patients. METHODS We measured NT-proBNP levels at admission and 72 hours in 72 patients with STEMI. HF events were adjudicated and defined as hospitalization for HF or need for new initiation of a loop diuretic at 1-year follow-up. Values are presented as medians and interquartile range or frequencies (%) as appropriate. Cox regression analysis was used to determine predictors of adverse events. A receiver-operative-curve was constructed to identify the discriminative value and optimal cut-off points for NT-proBNP. RESULTS Patients (age 56 [49-64] years, males 59 [82%]) were followed for a median duration of 365 [180-365] days. HF events were recorded in 9 (12.5%) patients. NT-proBNP values at admission, 72 hours, and ΔNT-proBNP were 89 (26-268) pg/mL, 452 (223-1064) pg/mL, and 283 (68-686) pg/mL, respectively. NT-proBNP at 72 hours and ΔNT-proBNP, but not admission NT-proBNP predicted new-onset HF events at follow-up (P=0.03, P=0.002 and P=0.89, respectively). The optimal area under the curve of 0.771 (95%, CI [0.630-0.912], P= 0.009) and cut-off value of 830 pg/mL (sensitivity 79%; specificity 76%) were found for NT-proBNP at 72 hours. The Kaplan-Meier survival curves for NT-proBNP at 72 hours dichotomized above and below this cut-off value, confirmed NT-proBNP at 72 hours >830 pg/mL as predictive of HF events (log-rank statistic = 8.688, P=0.003). CONCLUSIONS NT-proBNP level at 72 hours and ΔNT-proBNP (72 hours minus admission), but not at time of admission, predicted HF events in patients following STEMI.
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Affiliation(s)
- Marco G Del Buono
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
- Department of Cardiovascular and Thoracic Sciences, Sacred Heart Catholic University, Rome, Italy
| | - Cory R Trankle
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
| | - Leo Buckley
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Dinesh Kadariya
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
| | - Justin M Canada
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
| | - Salvatore Carbone
- Department of Kinesiology and Health Sciences, College of Humanities and Sciences, Virginia Commonwealth University, Richmond, VA, USA
| | - Jeremy Turlington
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
| | - Roshanak Markley
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
| | - Edoardo Bressi
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
| | - Benjamin W VAN Tassell
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA
- Department of Pharmacotherapy and Outcomes Science, Virginia Commonwealth University, Richmond, VA, USA
| | - Antonio Abbate
- Division of Cardiology, Department of Internal Medicine, Virginia Commonwealth University, Pauley Heart Center, Richmond, VA, USA -
- Department of Cardiovascular and Thoracic Sciences, Sacred Heart Catholic University, Rome, Italy
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Howarth C, Banerjee J, Eaton S, Aladangady N. Biomarkers of gut injury in neonates - where are we in predicting necrotising enterocolitis? Front Pediatr 2022; 10:1048322. [PMID: 36518779 PMCID: PMC9742605 DOI: 10.3389/fped.2022.1048322] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 11/07/2022] [Indexed: 11/29/2022] Open
Abstract
Despite advances in neonatal care Necrotising Enterocolitis (NEC) continues to have a significant mortality and morbidity rate, and with increasing survival of those more immature infants the population at risk of NEC is increasing. Ischaemia, reperfusion, and inflammation underpin diseases affecting intestinal blood flow causing gut injury including Necrotising Enterocolitis. There is increasing interest in tissue biomarkers of gut injury in neonates, particularly those representing changes in intestinal wall barrier and permeability, to determine whether these could be useful biomarkers of gut injury. This article reviews current and newly proposed markers of gut injury, the available literature evidence, recent advances and considers how effective they are in clinical practice. We discuss each biomarker in terms of its effectiveness in predicting NEC onset and diagnosis or predicting NEC severity and then those that will aid in surveillance and identifying those infants are greatest risk of developing NEC.
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Affiliation(s)
- Claire Howarth
- Neonatal Unit, Homerton Healthcare NHS Foundation Trust, London, United Kingdom
| | - Jayanta Banerjee
- Neonatal Unit, Imperial College Healthcare NHS Trust and Imperial College London, London, United Kingdom
| | - Simon Eaton
- University College London Great Ormond Street Institute of Child Health, London, England
| | - Narendra Aladangady
- Neonatal Unit, Homerton Healthcare NHS Foundation Trust, London, United Kingdom.,Barts and The London School of Medicine and Dentistry, Queen Mary University of London (QMUL), London, United Kingdom
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Cao Z, Jia Y, Zhu B. BNP and NT-proBNP as Diagnostic Biomarkers for Cardiac Dysfunction in Both Clinical and Forensic Medicine. Int J Mol Sci 2019; 20:ijms20081820. [PMID: 31013779 PMCID: PMC6515513 DOI: 10.3390/ijms20081820] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 04/09/2019] [Accepted: 04/11/2019] [Indexed: 12/23/2022] Open
Abstract
Currently, brain natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are widely used as diagnostic biomarkers for heart failure (HF) and cardiac dysfunction in clinical medicine. They are also used as postmortem biomarkers reflecting cardiac function of the deceased before death in forensic medicine. Several previous studies have reviewed BNP and NT-proBNP in clinical medicine, however, few articles have reviewed their application in forensic medicine. The present article reviews the biological features, the research and application status, and the future research prospects of BNP and NT-proBNP in both clinical medicine and forensic medicine, thereby providing valuable assistance for clinicians and forensic pathologists.
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Affiliation(s)
- Zhipeng Cao
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang 110122, China.
| | - Yuqing Jia
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang 110122, China.
| | - Baoli Zhu
- Department of Forensic Pathology, School of Forensic Medicine, China Medical University, Shenyang 110122, China.
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Rahmani R, Shafiee A, Parazaran K, Reshadati N. Predictive value of N-terminal-Pro brain natriuretic peptide in the detection of coronary artery disease in patients with positive myocardial perfusion imaging. Med J Islam Repub Iran 2019; 33:14. [PMID: 31086793 PMCID: PMC6504941 DOI: 10.34171/mjiri.33.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Indexed: 01/22/2023] Open
Abstract
Background: N-terminal pro-brain natriuretic peptide (NT-ProBNP) increases during myocardial ischemia and has a potential for the diagnosis of patients with coronary artery disease (CAD). We aimed to determine the incremental diagnostic value of NT-ProBNP in the selection of patients with positive myocardial perfusion imaging (MPI) for coronary angiography. We also tested the association between the level of NT-ProBNP and severity of CAD based on the vessel score and Gensini score.
Methods: In this cross-sectional study, stable angina patients with positive MPI who were assessed by coronary angiography in Imam Khomeini Hospitalwere enrolled. After the collection of demographic and clinical data, NT-ProBNP was measured in all patients on the day of coronary angiography, and its association with the presence of CAD, vessel score and Gensini score was tested.
Results: We enrolled 170 patients (mean age61.2±10.1 years, 86 males (50.6%)). Seventy-two (42.3%) patients had at least one stenotic vessel. NT-Pro BNP was significantly higher in the CAD-positive group (OR=1.01, 95% CI: 1.00-1.02; p=0.008) and could independently predict the presence of CAD at a cut-off point of 69.5, with a sensitivity of 55.6%, specificity of 82.5% and diagnostic accuracy of 61.7%. The Gensini score had a modest correlation with NT-Pro BNP (r=0.60, p<0.001). The combination of MPI result and NT-Pro BNP could predict the presence of CAD (OR=14.57, 95% CI: 4.28, 49.56; p<0.001).
Conclusion: Serum level of NT-Pro BNP alone and its combination with the results of MPI can significantly predict the presence of CAD and therefore, highlights the need for performing coronary angiography.
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Affiliation(s)
- Reza Rahmani
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Shafiee
- Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Parazaran
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Najmeh Reshadati
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Zolotovskaya IA, Davydkin II, Duplyakov DV, Kokorin VA. Predictive markers of atrial fibrillation in patients after acute ST-elevated myocardial infarction (the results of observational program “FAKEL”). КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2018. [DOI: 10.15829/1728-8800-2018-5-25-33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Aim. To assess probability of atrial fibrillation (AF) in patients after ST-elevated myocardial infarction (STEMI) with undergone primary percutaneous coronary intervention (PCI).Material and methods. Prospective study in the period from December 2015 to November 2017 was carried out with consecutive inclusion of 107 patients at outpatient follow-up stage after STEMI who have undergone primary PCI. The mean age of patients was 69,5+7,8 years (40 (37,4%) women). Follow-up period was 18 months and included three visits (V): V1 — when included in the study, V2 — after 12 months, and V3 — after 18 months. The endpoints of the study were cases of first diagnosed AF, cardioembolic stroke and death. At all visits predictive markers (Willebrand factor, Cystatin C, N-terminal prohormone of brain natriuretic peptide (NT-proBNP), galectin-3) in the blood plasma were determined.Results. After 18 months of follow-up period in 19 (17,8%) patients were diagnosed AF, 5 of them (4,7%) had cardioembolic stroke, and 3 patients died. Median time of AF development from the onset of STEMI was 308 days. Cox multivariate analysis showed that the risk factors for first diagnosed AF were NT-proBNP — relative risk (RR): 1,05; 95% confidence interval (CI): 0,99-1,10 (p=0,038), cystatin C — RR: 1,44; 95% CI: 0,98-2,12 (p=0,043), galectin-3 — RR: 1,20; 95% CI: 1,03-1,40 (p=0,022).Conclusion. There was a highly significant relationship between NT-proBNP of ≥400,0 pg/mL, cystatin С of ≥1,45 ng/mL and galectin-3 of ≥25 mg/mL in patients after STEMI who underwent primary PCI. These markers might serve as predictors of first diagnosed AF. Identification of these biomarkers may have potential therapeutic benefit in improving the prognosis of patients after STEMI who have undergone primary PCI and reduce mortality from cardioembolic stroke.
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Affiliation(s)
| | - I. I. Davydkin
- Samara State Medical University of the Ministry of Health
| | | | - V. A. Kokorin
- N.I. Pirogov Russian National Research Medical University of the Ministry of Health
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Lin KY, Wu ZY, You ZB, Zheng WP, Lin CJ, Jiang H, Ruan JM, Guo YS, Zhu PL. Pre-Procedural N-Terminal Pro-B Type Natriuretic Peptide Predicts Contrast-Induced Acute Kidney Injury and Long-Term Outcome in Elderly Patients After Elective Percutaneous Coronary Intervention. Int Heart J 2018; 59:926-934. [PMID: 30158378 DOI: 10.1536/ihj.17-573] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The aim of the study is to evaluate the association of pre-procedural N-terminal pro-B type natriuretic peptide (NT-proBNP) with contrast-induced acute kidney injury (CI-AKI) and long-term outcomes in elderly patients undergoing elective percutaneous coronary intervention (PCI).A total of 540 patients aged ≥ 75 years who had undergone elective PCI between January 2012 and December 2015 were enrolled in this study. Admission NT-proBNP levels were measured before PCI. CI-AKI was defined as a relative increase in serum creatinine (SCr) of ≥50%, or an absolute increase of ≥ 0.3 mg/dL, occurring within 48 hours after contrast medium exposure. The predictive value of NT-proBNP for predicting CI-AKI was assessed by receiver operating characteristic (ROC) and multivariable logistic regression analysis.A total of 54 (10.0%) patients developed CI-AKI. The best cutoff value of NT-pro-BNP for detecting CI-AKI was 1133 pg/mL with 66.7% sensitivity and 70.8% specificity according to the ROC analysis (C statistic = 0.719; 95% CI, 0.679-0.756). Multivariable analysis demonstrated that Lg-NT-proBNP is significantly related to CI-AKI (odds ratio [OR] = 3.892; 95% CI, 1.996-7.590; P < 0.001). Cox regression analysis showed that Lg-NT-proBNP is associated with long-term mortality (adjusted hazard ratio [HR] = 2.158; 95% CI, 1.246-3.740; P = 0.006) during follow-up.Pre-procedural NT-proBNP is a significant and independent predictor of CI-AKI and long-term mortality in elderly patients following elective PCI, and the best cutoff point for predicting CI-AKI was 1133 pg/mL.
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Affiliation(s)
- Kai-Yang Lin
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute
| | - Zhi-Yong Wu
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute
| | - Zhe-Bin You
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University
| | - Wei-Ping Zheng
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University
| | - Chun-Jin Lin
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University
| | - Hui Jiang
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute
| | - Jing-Ming Ruan
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University
| | - Yan-Song Guo
- Department of Cardiology, Fujian Provincial Hospital, Fujian Medical University, Fujian Cardiovascular Institute
| | - Peng-Li Zhu
- Department of Geriatric Medicine, Fujian Provincial Hospital, Fujian Provincial Institute of Clinical Geriatrics, Fujian Key Laboratory of Geriatrics, Fujian Provincial Center for Geriatrics, Fujian Medical University
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Gan L, Feng C, Liu C, Tian S, Song X, Yang L. Association between serum N-terminal pro-B-type natriuretic peptide levels and characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography. Exp Ther Med 2016; 12:667-675. [PMID: 27446259 PMCID: PMC4950222 DOI: 10.3892/etm.2016.3371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 01/15/2016] [Indexed: 12/15/2022] Open
Abstract
The aim of the present study was to explore the association between the levels of serum N-terminal pro-B-type natriuretic peptide (NT-pro BNP) and the characteristics of coronary atherosclerotic plaque detected by coronary computed tomography angiography (CCTA), in patients with unstable angina (UA). A total of 202 patients (age range, 47-82 years) were divided into the following three groups: Non-cardiac disease group (57 patients); stable angina pectoris (SAP) group (62 patients); and UA group (83 patients). There were significant differences between the serum NT-pro BNP levels among the three groups (P=0.007). However, in multivariant diagnoses, NT-pro BNP level was not an independent risk factor for UA. The levels of serum NT-pro BNP were observed to be positively correlated with the number of vessels involved (r=0.462; P<0.001), SIS (r=0.475; P<0.001), segment-stenosis score (r=0.453; P<0.001), coronary calcification score (r=0.412; P=0.001), number of obstructive diseases (r=0.346; P<0.001), and the number of segments with non-calcified plaque (r=0.235; P=0.017), mixed plaque (r=0.234; P=0.017) and calcified plaque (r=0.431; P<0.001). The levels of serum NT-pro BNP were significantly higher in patients with UA and left main-left anterior descending (LM-LAD) disease, compared with UA patients without LM-LAD disease (P<0.001). In addition, serum NT-pro BNP was significantly higher in patients with obstructive disease and UA than in those without obstructive disease (P<0.001). The area under the curve of log(NT-pro BNP) was 0.656 (P=0.006; optimal cut-off value, 1.74; sensitivity, 77.6%; specificity, 51.9%). In conclusion, the levels of serum NT-pro BNP are associated with the burden and severity of coronary artery atherosclerotic disease in patients with UA, and may be helpful in risk stratification of patients with UA.
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Affiliation(s)
- Lu Gan
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Cong Feng
- Department of Emergency, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Chunlei Liu
- The PLA Medical College, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Shuping Tian
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Xiang Song
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
| | - Li Yang
- Department of Radiology, General Hospital of the PLA, Beijing 100853, P.R. China
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N-terminal pro brain natriuretic peptide in coronary artery disease. J Saudi Heart Assoc 2015; 27:224. [PMID: 26136639 PMCID: PMC4481418 DOI: 10.1016/j.jsha.2014.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Accepted: 12/05/2014] [Indexed: 12/04/2022] Open
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