Predictive value of N-terminal pro-brain natriuretic peptide combined with coronary artery CT in the diagnosis of coronary heart disease / 中国医师进修杂志

ABSTRACT

Objective:To explore the predictive value of N-terminal pro-brain natriuretic peptide (NT-proBNP) combined with coronary CT in the final diagnosis of coronary artery disease.Methods:A total of 168 patients who were admitted to Dalian Friendship Hospital from August 2016 to August 2017 were randomly selected. The demographic data, clinical data and Gensini score of each selected patient were recorded. The patients were divided into coronary heart disease group (71 cases )and non coronary heart disease group (97 cases) according to the final results of coronary angiography. The demographic, clinical data and Gensini scores of the two groups were compared. The variables with significant differences were analyzed by multiple factors. The receptor working characteristic (ROC) curve of NT-proBNP for predicting patients with coronary heart disease was made.Results:The age, body mass index (BMI) , white blood cell count (WBC), Gensini score, the number of coronary artery lesions and the level of NT-proBNP of coronary heart disease group and non coronary heart disease group had significant differences [(65.8 ± 8.8) years vs. (58.8 ± 10.5) years, (27.5 ± 4.2) kg/m 2 vs. (23.3 ± 5.3) kg/m 2, (8.4 ± 2.6) × 10 9/L vs. (5.7 ± 2.2) × 10 9/L, (88.2 ± 12.0) scores vs. (43.3 ± 10.5) scores, 2.2 ± 1.1 vs. 1.1 ± 0.8, 72.1(28.0, 87.2) ng/L vs. 27.2(13.5, 34.6) ng/L, t=4.56, 2.43, 2.54, 7.89, 5.97, U=3 407.76, P<0.05]. Thirty-six patients (50.7%, 36/71) had diabetes history in coronary heart disease group and 24 patients (24.7%, 24/97) had diabetes history in non coronary heart disease group, and there was significant difference ( χ2= 12.04, P<0.05). Logistic analysis showed that coronary CT combined with NT-proBNP, age, history of diabetes mellitus and Gensini scores significantly increased the risk of final diagnosis of coronary artery disease, especially NT-proBNP ( OR = 14.57, 1.05, 2.48, 3.47, P<0.05). The results of ROC curve of NT -proBNP for predicting patients with coronary heart disease showed that the area under the curve was 0.899, with a sensitivity of 55.6% and a specificity of 82.6%, and critical value of the maximum Yoden index was 71.5 ng/L. Conclusions:NT-proBNP combined with coronary CT has predictive value for the final diagnosis of coronary heart disease, especially for patients with NT-proBNP over 71.5 ng/L. The patients who are initially diagnosed as coronary heart disease by coronary CT should be actively mobilized for coronary angiography.