N-terminal pro-brain-type natriuretic peptide concentration is associated with the extent of coronary artery disease in patients with chronic stable angina

Background - B-type natriuretic peptide (BNP) and its N-terminal fragment (NT-proBNP) have been shown to be elevated in patients with acute coronary syndromes and are also closely correlated with the patients 'outcome. Since there is paucity of data concerning proBNP in patients with stable angina pectoris, the present study was designed to assess whether NT-proBNP could predict the extent of coronary artery involvement in patients with stable angina pectoris. Methods and results - Seventy-three consecutive patients with stable angina pectoris undergoing coronary angiography were prospectively evaluated in the present study. In 23 (31.5%) patients relevant CAD was ruled out (no CAD). One- and two vessels disease with stenosis of ≥70% was found in 16 (21.9%) and 17 (23.3%) patients, respectively. Nine (12.3%) patients had 3 vessels disease with stenosis of ≥70%. In 8 (11%) patients coronary artery involvement was found to be minimal, i.e. with stenosis of <70%. NT-proBNP was elevated in patients in concordance with the extent of coronary artery disease (P<0.001). The area under the curve of the receiver operating characteristic curve was 0.77 for NT-proBNP to predict CAD (p<0.001). According to our results, using a cut off level of 30 pg/mL for NT-proBNP; CAD can be predicted by a sensitivity of 72% and specificity of 79%. Conclusion - NT-proBNP is elevated in patients with stable angina pectoris and is closely related with the severity of coronary artery involvement. The present study supports the valuable role of NT-proBNP in the diagnosis of CAD in patients with stable angina pectoris.