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)


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
Issue number8
Publication statusPublished - Aug 11 2008
Externally publishedYes



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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this