N terminal pro-brain natriuretic peptide level and benefits of chronic total occlusion revascularization.
Int J Cardiol
; 409: 132196, 2024 Aug 15.
Article
em En
| MEDLINE
| ID: mdl-38782069
ABSTRACT
BACKGROUND:
The management of revascularization of chronic total occlusions (CTOs) remains controversial. Whether specific patients gain survival benefit from CTO revascularization remains unknown.OBJECTIVES:
We investigated whether (i) patients with CTO have higher N terminal pro-brain natriuretic peptide (NT pro-BNP) levels than patients without CTO, (ii) in patients with CTO, NT pro-BNP levels predict adverse events, and (iii) those with elevated levels benefit from revascularization.METHODS:
In 392 patients with stable, significant coronary artery disease (CAD) and CTO undergoing coronary angiography, rates of all-cause mortality, cardiovascular death, and a composite (cardiovascular death, myocardial infarction and heart failure hospitalizations) were investigated. Unadjusted and adjusted Cox proportional and Fine and Gray sub-distribution hazard models were performed to determine the association between NT pro-BNP levels and incident event rates in patients with CTO.RESULTS:
NT pro-BNP levels were higher in patients with, compared to those without CTO (median 230.0 vs. 177.7 pg/mL, p ≤0.001). Every doubling of NT pro-BNP level in patients with CTO was associated with a > 25% higher rate of adverse events. 111 (28.5%) patients underwent CTO revascularization. In patients with elevated NT pro-BNP levels (> 125 pg/mL), those who underwent CTO revascularization had substantially lower adverse event rates compared to patients without CTO revascularization (adjusted cardiovascular death hazard ratio 0.29, 95% confidence interval (0.09-0.88). However, in patients with low NT pro-BNP levels (≤ 125 pg/mL), event rates were similar in those with and without CTO revascularization.CONCLUSION:
NT pro-BNP levels can help identify individuals who may benefit from CTO revascularization.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Fragmentos de Peptídeos
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Biomarcadores
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Peptídeo Natriurético Encefálico
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Oclusão Coronária
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Revascularização Miocárdica
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article