Role of N Terminal-Pro Brain Natriuretic Peptide in predicting the Severity of Coronary Artery Disease in Patients with Chronic Stable Angina

Abstract

Introduction: The aim of the study was to evaluate correlation between a noninvasive biomarker N terminal-pro brain natriuretic peptide (NT Pro BNP) and severity of coronary atherosclerosis in patients with chronic stable angina with preserved left ventricular systolic function. Material and Methods: 61 adult patients were included. The history regarding grade and duration of the anginal pain, risk factors, previous coronary revascularization, use of antiplatelets, antianginals, antihypertensives and other cardiovascular drugs were taken. Blood investigations namely fasting lipid profile and NT-Pro BNP level were done. A 2D echocardiography with colour Doppler was done to note left ventricular ejection fraction, Regional wall motion abnormality, Grade of left ventricular diastolic dysfunction and bilateral, common carotid artery intima media thickness. Angiography was done to evaluate coronary artery. Results: Male to female ratio was almost 2:1. Mean age of patients was 54.54 ± 8.89 years. Mean ejection fraction was 60.06 ± 3.11%. Mean Carotid intima and medial thickeness (CIMT) was more in patients with significant coronary artery disease than patients with non significant coronary artery disease (0.93±0.12 mm versus 0.91 ± 0.13 mm). Mean NT PRO BNP level in patients with non significant coronary artery disease was 87.88±19.41 pg/ml and significant coronary artery disease was 166.72 ± 82.86 pg/ml which is statistically significant (p=0.0001). Highest level of NT PRO BNP was 420 pg/ml noted in patient with triple vessel disease. Conclusion: non invasive NT-Pro BNP can be a good alternative of invasive angiography for assessment of severity of coronary artery disease.