N-Terminal Pro-B-Type Natriuretic Peptide is Associated with Severity of the Coronary Lesions in Unstable Angina Patients with Preserved Left Ventricular Function

Objectives: To evaluate the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) values and the severity of coronary lesions at angiography in unstable angina patients with preserved left ventricular function. Methods: A total of 133 patients with primary diagnosis of unstable angina were enrolled into this study. NT-proBNP level was determined before the angiography and Gensini score, a measurement of extent of myocardial ischemia, was calculated after the angiography by experienced cardiologists. Patients with >50% stenosis of the left main or 75% stenosis of one or more coronary branches with diameter >2 mm were defined as “angiography positive” and turned to percutaneous coronary intervention. Results: There was a significant difference of circulating NT-proBNP level between the angiography positive and negative groups and the median NT-proBNP values were 367.5 pg/mL and 112 pg/mL, respectively (P < 0.001). A significant correlation was observed between log NT-proBNP and log Gensini score (P < 0.001). NT-proBNP level was a predictor of angiography positive result and the area under the receiver operating characteristic curve was 0.776 (95% CI 0.693–0.858). Conclusions: NT-proBNP level was found to be higher with the severity of myocardial ischemia. However, the ability of NT-proBNP to identify clinically significant angiographic lesions was moderate. (J Interven Cardiol 2012;25:126–131)