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

Year 2019, Volume: 5 Issue: 6, 969 - 976, 04.11.2019

Bedrettin Boyraz Ferit Onur Mutluer Hakan Çakır Dursun Topal Mehmet Demir Fahri Er Tezcan Peker Mustafa Yılmaz Alkame Akgümüş Erhan Tenekecioğlu

https://doi.org/10.18621/eurj.447914

Abstract

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. 

Keywords

Natriuretic peptide, coronary artery disease, exercise stress test, myocardial ischemia

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