ABSTRACT
To analyze and evaluate predictive value of preoperative changes of serum levels of brain natri‐uretic peptide (BNP) and homocysteine (Hcy) levels for therapeutic effect and prognosis of coronary artery bypass grafting (CABG ) in patients undergoing CABG .Methods : Clinical data of 115 patients undergoing CABG in our hospital were collected .Preoperative serum levels of BNP and Hcy were compared among patients with different disease severity , therapeutic effect and prognosis .Influence of serum BNP and Hcy levels on therapeutic effect and prognosis of CABG were analyzed .Results : Compared with medium and mild disease group , there were significant rise in preoperative serum levels of BNP [ (151.86 ± 22.57) pg／L vs.(82.57 ± 10.26) pg／L vs.(283.51 ± 32.47) pg／L] and Hcy [ (18.37 ± 4.51) μmol／L vs.(12.74 ± 2. 04) μmol／L vs.(31.56 ± 5.17) μmol／L] in severe disease group , and those of medium disease group were significantly higher than those of mild disease group , P＝0.001 all ;compared with effective group and ineffective group , there were significant reductions in preoperative serum levels of BNP [ (227. 49 ± 24. 52) pg／L vs.(308.26 ± 34.12) pg／L vs.(90.13 ± 10. 75) pg／L] and Hcy [ (29. 12 ± 5. 83) μmol／L vs.(46.15 ± 7.49) μmol／L vs.(19.03 ± 3.77) μmol／L] in markedly effective group , and those of effec‐tive group were significantly lower than those of ineffective group , P＝ 0.001 all.Compared with stenotic graft group and smooth graft group , there were significant rise in preoperative serum levels of BNP [ (271. 47 ± 25.18) pg／L vs .(92.41 ± 11.06) pg／L vs.(312. 54 ± 35.06) pg／L] and Hcy [ (33.08 ± 6. 14) μmol／L vs.(20. 05 ± 3. 68) μmol／L vs.(50.21 ± 7.75 ) μmol／L ] in death group , and those of stenotic graft group were significantly higher than those of smooth graft group , P＝0.001 all .Spearman correlation analysis indicated that serum BNP and Hcy levels were significant positively correlated with severity of CHD and prognosis of CABG ( r＝0. 624～0.814 , P＜0.05 or ＜0. 01).Multifactor Logistic regression analysis indicated that serum BNP and Hcy levels were independent risk factors for prognosis after CABG in CHD patients (OR＝ 5.133 , 1. 803 , P＝ 0.001 both ).Conclusion : The higher preoperative levels of BNP and Hcy before CABG are , the worse therapeutic effects are , and the higher risk of adverse prognosis of vascular stenosis and death are .