NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease 英文参考文献.docVIP

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NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease 英文参考文献.doc

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NT-proBNP and Circulating Inflammation Markers in Prediction of a Normal Myocardial Scintigraphy in Patients with Symptoms of Coronary Artery Disease 英文参考文献

NT-proBNPandCirculatingInflammationMarkersin PredictionofaNormalMyocardialScintigraphyin PatientswithSymptomsofCoronaryArteryDisease CamillaNoelleRathcke1*,ErikKj?ller2,NielsFogh-Andersen3,BoZerahn4,HenrikVestergaard1,5 1Department of Internal Medicine, Center of Endocrinology and Metabolism, Copenhagen University Hospital Herlev, Herlev, Denmark, 2Department of Cardiology, CopenhagenUniversityHospitalHerlev,Herlev,Denmark,3DepartmentofClinicalBiochemistry,CopenhagenUniversityHospitalHerlev,Herlev,Denmark,4Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev, Herlev, Denmark, 5Faculty of Health Sciences, University of Copenhagen, Copenhagen,Denmark Abstract Background:Myocardialperfusionimaging(MPI)candetectmyocardialperfusionabnormalitiesbutmanyexaminationsare withoutpathologicalfindings.Thisstudyexamineswhethercirculatingbiomarkerscanbeusedasscreeningmodalityprior toMPI. Methodology/Principal Findings: 243 patients with an intermediate risk of CAD or with known CAD with renewed suspicionofischemiawerereferredtoMPI.BloodsampleswereanalyzedforN-terminalfragmentoftheprohormonebrain natriuretic peptide (NT-proBNP), YKL-40, IL-6, matrix metalloproteinase 9 (MMP-9) and high sensitive C-reactive protein (hsCRP).PatientswithmyocardialperfusiondefectshadelevatedlevelsofNT-proBNP(p,0.0001),YKL-40(p=0.03)andIL-6 (p=0.03) but not of hsCRP (p=0.58) nor of MMP-9 (p=0.14). The NT-proBNP increase was observed in both genders (p,0.0001),whereasYKL-40(p=0.005)andIL-6(p=0.02)wereelevatedonlyinmen.ANT-proBNPcutoff-concentrationat 25ng/lpredictedanormalMPIwithanegativepredictivevalue.95%regardlessofexistingCAD. Conclusions: 20-25% of patients suspected of CAD could have been spared a MPI by using a NT-proBNP cut-off concentration at 25ng/l with a negative predictive value .95%. NT-proBNP has the potential use of being a screening markerofCADbeforereferralofthepatienttoMPI. Citation:RathckeCN,Kj?llerE,Fogh-AndersenN,ZerahnB,VestergaardH(2010)N