Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease

Dao Fu Dai, Juey Jen Hwang, Jiunn Lee Lin, Jou Wei Lin, Chih Neng Hsu, Chih Min Lin, Fu Tien Chiang, Ling Ping Lai, Kwan Lih Hsu, Chuen Den Tseng, Yung Zu Tseng

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background: This study was designed to evaluate the joint effects of plasma C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) vs coronary angiographic severity on cardiovascular risk stratification. Methods and Results: A total of 345 patients with stable coronary artery disease (CAD) were recruited after successful percutaneous coronary intervention (PCI). Endpoints were major adverse cardiovascular events (MACE) and cumulative clinical restenosis rate after 18-36-month follow-up. Plasma NT-proBNP and CRP levels were among the strongest predictors of MACE. Adjusted hazard ratios of MACE according to combined biomarkers were 2.4 (p=0.05) for elevated CRP only, 5.22 (p<0.001) for elevated NT-proBNP only, and 7.04 (p<0.001) for elevation of both. The differential capacity using both plasma CRP and NT-proBNP in a receiver-operating-characteristics curve analysis (area under curve, AUC: 0.82) was significantly higher than using eiflier biomarker alone or conventional risk factors (AUC: 0.67). Significant predictors of clinical restenosis were plasma NT-proBNP and the Gensini score. The combination of NT-proBNP and the Gensini score was the strongest predictor (AUC: 0.77) for clinical restenosis. Conclusions: Plasma NT-proBNP, CRP, and the Gensini score are complementary in risk stratification. Combined use of these biomarkers has provided substantial extra information to conventional risk factors in stable CAD patients.

Original languageEnglish
Pages (from-to)1316-1323
Number of pages8
JournalCirculation Journal
Volume72
Issue number8
DOIs
Publication statusPublished - Aug 11 2008
Externally publishedYes

Fingerprint

Coronary Restenosis
Brain Natriuretic Peptide
Angioplasty
C-Reactive Protein
Coronary Artery Disease
Area Under Curve
Biomarkers
Blood Proteins
Percutaneous Coronary Intervention
polypeptide C
ROC Curve

Keywords

  • Brain
  • C-reactive protein (CRP)
  • Coronary artery disease
  • Natriuretic peptides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease. / Dai, Dao Fu; Hwang, Juey Jen; Lin, Jiunn Lee; Lin, Jou Wei; Hsu, Chih Neng; Lin, Chih Min; Chiang, Fu Tien; Lai, Ling Ping; Hsu, Kwan Lih; Tseng, Chuen Den; Tseng, Yung Zu.

In: Circulation Journal, Vol. 72, No. 8, 11.08.2008, p. 1316-1323.

Research output: Contribution to journalArticle

Dai, Dao Fu ; Hwang, Juey Jen ; Lin, Jiunn Lee ; Lin, Jou Wei ; Hsu, Chih Neng ; Lin, Chih Min ; Chiang, Fu Tien ; Lai, Ling Ping ; Hsu, Kwan Lih ; Tseng, Chuen Den ; Tseng, Yung Zu. / Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease. In: Circulation Journal. 2008 ; Vol. 72, No. 8. pp. 1316-1323.
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abstract = "Background: This study was designed to evaluate the joint effects of plasma C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) vs coronary angiographic severity on cardiovascular risk stratification. Methods and Results: A total of 345 patients with stable coronary artery disease (CAD) were recruited after successful percutaneous coronary intervention (PCI). Endpoints were major adverse cardiovascular events (MACE) and cumulative clinical restenosis rate after 18-36-month follow-up. Plasma NT-proBNP and CRP levels were among the strongest predictors of MACE. Adjusted hazard ratios of MACE according to combined biomarkers were 2.4 (p=0.05) for elevated CRP only, 5.22 (p<0.001) for elevated NT-proBNP only, and 7.04 (p<0.001) for elevation of both. The differential capacity using both plasma CRP and NT-proBNP in a receiver-operating-characteristics curve analysis (area under curve, AUC: 0.82) was significantly higher than using eiflier biomarker alone or conventional risk factors (AUC: 0.67). Significant predictors of clinical restenosis were plasma NT-proBNP and the Gensini score. The combination of NT-proBNP and the Gensini score was the strongest predictor (AUC: 0.77) for clinical restenosis. Conclusions: Plasma NT-proBNP, CRP, and the Gensini score are complementary in risk stratification. Combined use of these biomarkers has provided substantial extra information to conventional risk factors in stable CAD patients.",
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T1 - Joint effects of N-terminal pro-B-type-natriuretic peptide and C-reactive protein vs angiographic severity in predicting major adverse cardiovascular events and clinical restenosis after coronary angioplasty in patients with stable coronary artery disease

AU - Dai, Dao Fu

AU - Hwang, Juey Jen

AU - Lin, Jiunn Lee

AU - Lin, Jou Wei

AU - Hsu, Chih Neng

AU - Lin, Chih Min

AU - Chiang, Fu Tien

AU - Lai, Ling Ping

AU - Hsu, Kwan Lih

AU - Tseng, Chuen Den

AU - Tseng, Yung Zu

PY - 2008/8/11

Y1 - 2008/8/11

N2 - Background: This study was designed to evaluate the joint effects of plasma C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) vs coronary angiographic severity on cardiovascular risk stratification. Methods and Results: A total of 345 patients with stable coronary artery disease (CAD) were recruited after successful percutaneous coronary intervention (PCI). Endpoints were major adverse cardiovascular events (MACE) and cumulative clinical restenosis rate after 18-36-month follow-up. Plasma NT-proBNP and CRP levels were among the strongest predictors of MACE. Adjusted hazard ratios of MACE according to combined biomarkers were 2.4 (p=0.05) for elevated CRP only, 5.22 (p<0.001) for elevated NT-proBNP only, and 7.04 (p<0.001) for elevation of both. The differential capacity using both plasma CRP and NT-proBNP in a receiver-operating-characteristics curve analysis (area under curve, AUC: 0.82) was significantly higher than using eiflier biomarker alone or conventional risk factors (AUC: 0.67). Significant predictors of clinical restenosis were plasma NT-proBNP and the Gensini score. The combination of NT-proBNP and the Gensini score was the strongest predictor (AUC: 0.77) for clinical restenosis. Conclusions: Plasma NT-proBNP, CRP, and the Gensini score are complementary in risk stratification. Combined use of these biomarkers has provided substantial extra information to conventional risk factors in stable CAD patients.

AB - Background: This study was designed to evaluate the joint effects of plasma C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) vs coronary angiographic severity on cardiovascular risk stratification. Methods and Results: A total of 345 patients with stable coronary artery disease (CAD) were recruited after successful percutaneous coronary intervention (PCI). Endpoints were major adverse cardiovascular events (MACE) and cumulative clinical restenosis rate after 18-36-month follow-up. Plasma NT-proBNP and CRP levels were among the strongest predictors of MACE. Adjusted hazard ratios of MACE according to combined biomarkers were 2.4 (p=0.05) for elevated CRP only, 5.22 (p<0.001) for elevated NT-proBNP only, and 7.04 (p<0.001) for elevation of both. The differential capacity using both plasma CRP and NT-proBNP in a receiver-operating-characteristics curve analysis (area under curve, AUC: 0.82) was significantly higher than using eiflier biomarker alone or conventional risk factors (AUC: 0.67). Significant predictors of clinical restenosis were plasma NT-proBNP and the Gensini score. The combination of NT-proBNP and the Gensini score was the strongest predictor (AUC: 0.77) for clinical restenosis. Conclusions: Plasma NT-proBNP, CRP, and the Gensini score are complementary in risk stratification. Combined use of these biomarkers has provided substantial extra information to conventional risk factors in stable CAD patients.

KW - Brain

KW - C-reactive protein (CRP)

KW - Coronary artery disease

KW - Natriuretic peptides

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U2 - 10.1253/circj.72.1316

DO - 10.1253/circj.72.1316

M3 - Article

VL - 72

SP - 1316

EP - 1323

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

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