Year 2019, Volume 5 , Issue 6, Pages 969 - 976 2019-11-04

Role of B-type natriuretic peptide in diagnosis of coronary artery disease

Bedrettin Boyraz [1] , Ferit Onur Mutluer [2] , Hakan Çakır [3] , Dursun Topal [4] , Mehmet Demir [5] , Fahri Er [6] , Tezcan Peker [7] , Mustafa Yılmaz [8] , Alkame Akgümüş [9] , Erhan Tenekecioğlu [10]


Objectives: B-type natriuretic peptide (BNP) has been extensively studied as a biomarker in heart failure. There is clear benefit of BNP in diagnosis and risk stratification of several cardiac diseases including acute coronary syndromes. Our aim was to evaluate diagnostic role of changes in BNP levels with exercise in coronary artery disease (CAD).

Methods: Fifty-one patients underwent exercise stress testing (EST) for suspected CAD and consequently underwent coronary angiography (CA) were prospectively enrolled. Patients with and without at least one significant diameter stenosis in major epicardial arteries (CA+ and CA-) versus patients with and without evidence of myocardial ischemia during exercise stress testing (EST+ and EST-) were classified into 4 groups, respectively (Group 1, CA+/EST+; group 2, CA+/EST-; group 3, CA-/EST+; and group 4, CA-/EST-). All patients underwent EST. Blood was drawn from patients for determination of BNP levels 10 minutes prior to, 10 minutes after and 4 hours after EST.

Results: EST parameters other than the parameters signifying myocardial ischemia didn’t differ significantly among groups (p > 0.05). Pre-exercise, post-exercise and 4h-post exercise BNP values were significantly higher in group 1 and group 2 compared to group 3 and group 4 (p < 0.05 for all comparisons between the groups for pre-exercise, post-exercise and 4h-post exercise BNP). Exercise-induced increases in BNP were higher in group 1 and group 2. Patients with significant CAD involving LAD demonstrated higher basal and exercise-induced BNP as well as BNP increases, irrespective of the EST result.

Conclusions: Basal, maximal-exercise and post exercise BNP values predicted CAD, as well as CAD involving LAD irrespective of ischemic changes in EST. Our results point out potential role of BNP as an adjunct to EST in diagnosis and management of CAD. 

Natriuretic peptide, coronary artery disease, exercise stress test, myocardial ischemia
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Primary Language en
Subjects Cardiac and Cardiovascular Systems
Journal Section Original Articles
Authors

Orcid: 0000-0003-1831-182X
Author: Bedrettin Boyraz (Primary Author)
Institution: Department of Cardiology, Tatvan State Hospital, Bitlis, Turkey
Country: Turkey


Orcid: 0000-0001-9114-9529
Author: Ferit Onur Mutluer
Institution: Department of Cardiology, Koç University School of Medicine, İstanbul, Turkey
Country: Turkey


Orcid: 0000-0003-3042-9337
Author: Hakan Çakır
Institution: Department of Cardiology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0001-7053-2131
Author: Dursun Topal
Institution: Department of Cardiology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0003-2216-6258
Author: Mehmet Demir
Institution: Department of Cardiology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0002-5016-5511
Author: Fahri Er
Institution: Department of Cardiology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0002-2489-5430
Author: Tezcan Peker
Institution: Department of Cardiology, Bursa Doruk Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0002-3616-0028
Author: Mustafa Yılmaz
Institution: Department of Cardiology, Uludağ University School of Medicine, Bursa, Turkey
Country: Turkey


Orcid: 0000-0002-4286-8997
Author: Alkame Akgümüş
Institution: Department of Cardiology, Gemlik State Hospital, Bursa, Turkey
Country: Turkey


Orcid: 0000-0003-4376-2833
Author: Erhan Tenekecioğlu (Primary Author)
Institution: Department of Cardiology, University of Health Sciences, Bursa Yüksek İhtisas Training and Research Hospital, Bursa, Turkey
Country: Turkey


Dates

Publication Date : November 4, 2019

EndNote %0 The European Research Journal Role of B-type natriuretic peptide in diagnosis of coronary artery disease %A Bedrettin Boyraz , Ferit Onur Mutluer , Hakan Çakır , Dursun Topal , Mehmet Demir , Fahri Er , Tezcan Peker , Mustafa Yılmaz , Alkame Akgümüş , Erhan Tenekecioğlu %T Role of B-type natriuretic peptide in diagnosis of coronary artery disease %D 2019 %J The European Research Journal %P -2149-3189 %V 5 %N 6 %R doi: 10.18621/eurj.447914 %U 10.18621/eurj.447914