B-type natriuretic peptide (BNP) have been used to identify patients with congestive heart failure (CHF) and independent predictor of sudden cardiac death. Few studies identified the significance of Pro-N-BNP in patients with separated entities as IHD without heart failure.The purpose of this paper is to determine the value of N-terminal pro-Brain Natriuretic Peptide (NT-proBNP) in patients with ischemic heart disease and its relationship to the severity and the number of coronary artery involved. however the patients sample that used One hundred and sixty two patients (162) (107 male and 55 female) with suspected coronary artery disease referred to our catheterization lab at Iraqi center for heart diseases for coronary angiography between JANUARY - July2018 were subjected to measurement of the blood NT pro BNP level at the date of coronary angiography. All the patients underwent full clinical evaluation, echocardiography as being assessed by conventional echocardiography and TDI. The patients were classified into two groups according to the angiographic findings: Group I had normal coronary angiography, fifty eight( 58) patients and group II had significant coronary artery disease on hundred and four (104) patients. The patients with coronary artery disease (group II) were further sub divided according to the severity of coronary artery lesion to II a: who have critical lesion (70-90% stenosis), II b: those with subtotal occlusion (90-99%) and II c those with total 100% occlusion. Group II was further subdivided into: IIA2: the patients with significant coronary lesion and have normal left ventricula systolic and diastolic function II B2 : the patients with significant coronary lesion and have abnormal systolic and/or diastolic function. While there was no statistically significant difference between group I (control group) and group II (patient group) regarding the demographic variables, the blood NT pro BNP level was significantly higher in group II. It ranged from 17 to 362.5 pg/ml with a mean ± SD of 74.68±33.92 in group Iin comparison to with a mean ± SD of 1199.97±569.58 then we study statistic relationship of each subgroup with level of N- terminal pro- BNP by one way and two wayANOVA TEST. There was staistiacl significant relation between the level of po BNP ad the severity of coronary artery stenosis ( IIa,II b,IIc) . p value= 0.00001. The Receiver-Operating Characteristics (ROC) curve showed that cut off point of NT pro BNP level for predicting CAD is > 15 Pg/mL with sensitivity 79.4% and specificity 77.3 %. .There was also singnicant elation between po BNP and the number of vesssel involved ( single vessel esult , two vessel result , three vessels result) p value=0.02.When we compare the relation of por BNP level ant left venticula fucntions ( systolic and diastolic ) we find a significant assosciation between the level of pro BNP and coronary artery lesion e in patient with normal systolic and diastolic functions p value = 0.001 Finally the patients with IHD with or without LV functions (systolic and diastolic ), measurement of the NT-proBNP blood level is a useful tool for prediction and assessment of the severity of CAD.
Volume 11 | 01-Special Issue
Pages: 355-367