NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery DiseaseReportar como inadecuado




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Background

Myocardial perfusion imaging MPI can detect myocardial perfusion abnormalities but many examinations are without pathological findings. This study examines whether circulating biomarkers can be used as screening modality prior to MPI.

Methodology-Principal Findings

243 patients with an intermediate risk of CAD or with known CAD with renewed suspicion of ischemia were referred to MPI. Blood samples were analyzed for N-terminal fragment of the prohormone brain natriuretic peptide NT-proBNP, YKL-40, IL-6, matrix metalloproteinase 9 MMP-9 and high sensitive C-reactive protein hsCRP. Patients with myocardial perfusion defects had elevated levels of NT-proBNP p<0.0001, YKL-40 p = 0.03 and IL-6 p = 0.03 but not of hsCRP p = 0.58 nor of MMP-9 p = 0.14. The NT-proBNP increase was observed in both genders p<0.0001, whereas YKL-40 p = 0.005 and IL-6 p = 0.02 were elevated only in men. A NT-proBNP cut off-concentration at 25 ng-l predicted a normal MPI with a negative predictive value >95% regardless of existing CAD.

Conclusions

20-25% of patients suspected of CAD could have been spared a MPI by using a NT-proBNP cut-off concentration at 25 ng-l with a negative predictive value >95%. NT-proBNP has the potential use of being a screening marker of CAD before referral of the patient to MPI.



Autor: Camilla Noelle Rathcke , Erik Kjøller, Niels Fogh-Andersen, Bo Zerahn, Henrik Vestergaard

Fuente: http://plos.srce.hr/



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