PURPOSE: To examine whether coronary artery stenosis affects plasma levels of atrial natriuretic peptide (ANP), N-terminal proatrial natriuretic peptide (proANP), and brain natriuretic peptide (BNP) in patients with normal left ventricular systolic function. METHODS: We studied 104 consecutive patients with normal left ventricular function and suspected coronary artery stenosis. Plasma natriuretic peptide levels were measured by immunoradiometric assays. RESULTS: Plasma levels of ANP, N-terminal proANP, and BNP were higher in patients with (n = 65) than in those without (n = 39) coronary artery stenosis, whereas hemodynamic variables were similar. Patients who had coronary artery stenosis with only distal lesions (n = 36) had higher levels of all three natriuretic peptides than did patients with no coronary artery stenosis. N-terminal proANP levels were significantly higher in patients who had coronary artery stenosis with proximal lesions (n = 29) than in patients who had coronary artery stenosis with only distal lesions and those with no coronary artery stenosis. Multiple logistic regression analysis revealed that N-terminal proANP, but not ANP or BNP, was independently associated with coronary artery stenosis after adjusting for clinical and demographic variables (odds ratio per 100 fmol/mL increase = 1.9; 95% confidence interval: 1.9 to 2.6; P = 0.01). However, the sensitivity, specificity, and positive and negative predictive values of each peptide were not sufficiently high to be used for prediction. CONCLUSION: N-terminal proANP may be associated with clinically important coronary artery stenosis in patients with normal left ventricular systolic function, but its clinical usefulness may be limited.
PURPOSE: To examine whether coronary artery stenosis affects plasma levels of atrial natriuretic peptide (ANP), N-terminal proatrial natriuretic peptide (proANP), and brain natriuretic peptide (BNP) in patients with normal left ventricular systolic function. METHODS: We studied 104 consecutive patients with normal left ventricular function and suspected coronary artery stenosis. Plasma natriuretic peptide levels were measured by immunoradiometric assays. RESULTS: Plasma levels of ANP, N-terminal proANP, and BNP were higher in patients with (n = 65) than in those without (n = 39) coronary artery stenosis, whereas hemodynamic variables were similar. Patients who had coronary artery stenosis with only distal lesions (n = 36) had higher levels of all three natriuretic peptides than did patients with no coronary artery stenosis. N-terminal proANP levels were significantly higher in patients who had coronary artery stenosis with proximal lesions (n = 29) than in patients who had coronary artery stenosis with only distal lesions and those with no coronary artery stenosis. Multiple logistic regression analysis revealed that N-terminal proANP, but not ANP or BNP, was independently associated with coronary artery stenosis after adjusting for clinical and demographic variables (odds ratio per 100 fmol/mL increase = 1.9; 95% confidence interval: 1.9 to 2.6; P = 0.01). However, the sensitivity, specificity, and positive and negative predictive values of each peptide were not sufficiently high to be used for prediction. CONCLUSION: N-terminal proANP may be associated with clinically important coronary artery stenosis in patients with normal left ventricular systolic function, but its clinical usefulness may be limited.
Authors: Lafayete William F Ramos; Neif Murad; Eduardo Goto; Edinei L Antônio; José A Silva; Paulo F Tucci; Antônio C Carvalho Journal: Heart Vessels Date: 2009-11-22 Impact factor: 2.037
Authors: C M Gijsberts; A Seneviratna; I E M Bank; H M den Ruijter; F W Asselbergs; P Agostoni; J A Remijn; G Pasterkamp; H C Kiat; M Roest; A M Richards; M Y Chan; D P V de Kleijn; I E Hoefer Journal: Neth Heart J Date: 2016-03 Impact factor: 2.380