Angina Research Today is a free monthly online journal that collates and summarizes the latest research about Angina, including details on symptoms, treatment, causes, prevention, surgery.

Analysis of N-terminal-pro-brain natriuretic peptide and C-reactive protein for risk stratification in stable and unstable coronary artery disease: results from the AtheroGene study.

Schnabel R, Rupprecht HJ, Lackner KJ, Lubos E, Bickel C, Meyer J, Münzel T, Cambien F, Tiret L, Blankenberg S,

Department of Medicine II, Johannes Gutenberg-University Mainz, Langenbeckstr. 1, 55131 Mainz, Germany. schnabelr@web.de

AIMS: N-terminal-pro-brain natriuretic peptide (Nt-proBNP) is a reliable risk predictor in acute coronary artery disease (CAD). Little is known about patients with stable angina pectoris (SAP). We aimed to investigate the prognostic impact of Nt-proBNP in a population with CAD especially focussing on patients with SAP. METHODS AND RESULTS: We obtained baseline samples from a prospective cohort of 904 consecutive patients with CAD. Cardiovascular events were registered during follow-up (median 2 years; maximum 3.7 years). Baseline Nt-proBNP was significantly higher among individuals with cardiovascular events compared with those without (711.5 vs. 238.8 pg/mL; P<0.0001). A similar association was found if the analysis was performed in patients who presented with stable angina (330 vs. 166.5 pg/mL; P=0.006) or acute coronary syndrome (990.9 vs. 527.7 pg/mL; P=0.03). In the SAP group, patients within the top quartile (>487.9 pg/mL) had a 3.7-fold (95% CI 1.2-9.1; P=0.01) increase in cardiovascular risk. After adjustment for most potential confounders including left ventricular ejection fraction, Nt-proBNP remained predictive for patients with serum concentrations in the upper quartile in comparison with patients in the lowest quartile (hazard ratio highest vs. lowest quartile: 4.0; P=0.03) (n=417). CONCLUSION: Baseline concentration of Nt-proBNP is independently related to future cardiovascular events in patients with stable angina.

Published 21 January 2005 in Eur Heart J, 26(3): 241-9.
Full-text of this article is available online (may require subscription).

© 2004-2008 Angina Research Today. All Rights Reserved.