Prognostic Value of Serum BNP in Patients with NSTEMI and Its Correlation with Extent of Coronary Artery Disease

Document Type : Original Article

Authors

1 Faculty of Medicine, Zagazig University, Department of Cardiology,Zagazig, Egypt

2 Cardiology Department, Faculty of Medicine, Zagazig University

3 cardiology department,zagazig university,zagazig

4 Cardiology department,agouza police hospital,medical services sector,ministery of interior.

Abstract

Background: BNP biomarker is found to have positive correlation to coronary artery disease (CAD). So it may have diagnostic and prognostic value.
The aim to predict the prognostic value of serum BNP level as biomarker and the severity of CAD in NSTEMI with normal left ventricular systolic function, as regards both SYNTAX score and GRACE score.
Methods: We enrolled patients with NSTEMI and normal LV systolic function (LV EF ≥50%). Grace score was calculated. All patient underwent BNP analysis, echocardiography and coronary angiography within 24 to 72 hours of admission. SYNTAX score was calculated.
Results: Sixty-four patients with NSTEMI with mean GRACE score 140.41 ±28.5 and mean SYNTAX score 17.39 ±9.8 were enrolled. BNP level was 135.17 ±37.9ng/dL. According to the level of serum BNP, Patients were divided into 2 groups, first group with high BNP (>80 ng/dl) and second group with low serum BNP level. The results show significant differences between both groups regarding GRACE score (p =0.001) and SYNTAX score (p =0.001).Also there were significant positive correlations between BNP and age (p =0.001), Grace score (p =0.001), and SYNTAX score (p =0.001). At a cutoff of 141pg/dL, the BNP yielded a sensitivity of 83% and specificity of 75% for prediction of SYNTAX score of more than 32.
Conclusion: Serum BNP level as abiomarker provides independent prognostic value in NSTEMI patients. Patients with high serum BNP level were more likely to have higher GRACE and SYNTAX scores. Serum BNP level had a good diagnostic accuracy in predicting SYNTAX score.

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