Background: Natriuretic peptides are diagnostic/prognostic biomarkers in major cardiovascular diseases. We aimed at assessing the predictive role of N-terminal pro-A-type (NT-proANP) and pro-B-type (NT-proBNP) natriuretic peptides levels toward cardiovascular outcome in both stable and unstable coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in a non-primary PCI setting. Methods: A total of 395 patients undergoing PCI with stent implantation for either stable angina (SA) or non ST-elevation acute coronary syndrome (NSTE-ACS) were enrolled. Pre-procedural NT-proANP and NT-proBNP levels were measured. Occurrence of major adverse cardiac events (MACEs), composite of cardiac death, non-fatal myocardial infarction, and clinically driven target lesion revascularization (c-TLR), was the endpoint of the study. Follow up mean time was 48.53 ± 14.69 months. Results: MACEs occurred in forty-four patients (11%) during follow up. Both NT-proANP levels [3170 (2210-4630) vs 2283 (1314-3913) fmol/mL, p = 0.004] and NT-proBNP levels [729 (356-1353) vs 511 (267-1006) fmol/mL, p = 0.04] were significantly higher in patients with MACEs compared to patients without MACEs. Similar results were found when considering hard MACEs (myocardial infarction and cardiac death). NT-proANP levels were significantly higher in patients with c-TLR compared with patients without c-TLR [3705 (2766-5184) vs 2343 (1340-3960) fmol/mL, p = 0.021]. At multivariate analysis, NT-proANP levels were a significant predictor of MACEs (HR 1.09, 95% CI 1.03-1.18, p = 0.04). Kaplan-Meyer curves revealed that patients with elevated NT-proANP levels (>. 2.100 fmol/mL) had a lower MACE free survival (p = 0.003). Conclusions: Both NT-proANP and NT-proBNP levels were higher in CAD patients experiencing MACEs following PCI in a non-primary setting. Notably, only NT-proANP levels significantly affected prognosis after PCI.

NT-proANP and NT-proBNP circulating levels as predictors of cardiovascular outcome following coronary stent implantation / Niccoli, Giampaolo; Conte, Micaela; Marchitti, Simona; Montone, Rocco A.; Fracassi, Francesco; Grippo, Rocco; Roberto, Marco; Burzotta, Francesco; Trani, Carlo; Leone, Antonio Maria; Bianchi, Franca; DI CASTRO, Sara; Volpe, Massimo; Crea, Filippo; Rubattu, Speranza Donatella. - In: CARDIOVASCULAR REVASCULARIZATION MEDICINE. - ISSN 1553-8389. - ELETTRONICO. - 17:3(2016), pp. 162-168. [10.1016/j.carrev.2016.02.012]

NT-proANP and NT-proBNP circulating levels as predictors of cardiovascular outcome following coronary stent implantation

MARCHITTI, Simona;DI CASTRO, SARA;VOLPE, Massimo;RUBATTU, Speranza Donatella
2016

Abstract

Background: Natriuretic peptides are diagnostic/prognostic biomarkers in major cardiovascular diseases. We aimed at assessing the predictive role of N-terminal pro-A-type (NT-proANP) and pro-B-type (NT-proBNP) natriuretic peptides levels toward cardiovascular outcome in both stable and unstable coronary artery disease (CAD) patients after percutaneous coronary intervention (PCI) in a non-primary PCI setting. Methods: A total of 395 patients undergoing PCI with stent implantation for either stable angina (SA) or non ST-elevation acute coronary syndrome (NSTE-ACS) were enrolled. Pre-procedural NT-proANP and NT-proBNP levels were measured. Occurrence of major adverse cardiac events (MACEs), composite of cardiac death, non-fatal myocardial infarction, and clinically driven target lesion revascularization (c-TLR), was the endpoint of the study. Follow up mean time was 48.53 ± 14.69 months. Results: MACEs occurred in forty-four patients (11%) during follow up. Both NT-proANP levels [3170 (2210-4630) vs 2283 (1314-3913) fmol/mL, p = 0.004] and NT-proBNP levels [729 (356-1353) vs 511 (267-1006) fmol/mL, p = 0.04] were significantly higher in patients with MACEs compared to patients without MACEs. Similar results were found when considering hard MACEs (myocardial infarction and cardiac death). NT-proANP levels were significantly higher in patients with c-TLR compared with patients without c-TLR [3705 (2766-5184) vs 2343 (1340-3960) fmol/mL, p = 0.021]. At multivariate analysis, NT-proANP levels were a significant predictor of MACEs (HR 1.09, 95% CI 1.03-1.18, p = 0.04). Kaplan-Meyer curves revealed that patients with elevated NT-proANP levels (>. 2.100 fmol/mL) had a lower MACE free survival (p = 0.003). Conclusions: Both NT-proANP and NT-proBNP levels were higher in CAD patients experiencing MACEs following PCI in a non-primary setting. Notably, only NT-proANP levels significantly affected prognosis after PCI.
2016
cardiovascular risk; NT-proANP; NT-proBNP; percutaneous coronary intervention; cardiology and cardiovascular medicine
01 Pubblicazione su rivista::01a Articolo in rivista
NT-proANP and NT-proBNP circulating levels as predictors of cardiovascular outcome following coronary stent implantation / Niccoli, Giampaolo; Conte, Micaela; Marchitti, Simona; Montone, Rocco A.; Fracassi, Francesco; Grippo, Rocco; Roberto, Marco; Burzotta, Francesco; Trani, Carlo; Leone, Antonio Maria; Bianchi, Franca; DI CASTRO, Sara; Volpe, Massimo; Crea, Filippo; Rubattu, Speranza Donatella. - In: CARDIOVASCULAR REVASCULARIZATION MEDICINE. - ISSN 1553-8389. - ELETTRONICO. - 17:3(2016), pp. 162-168. [10.1016/j.carrev.2016.02.012]
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