Prognostic value of NT-proBNP in patients with chronic coronary syndrome and normal left ventricular systolic function according to glucose status: a prospective cohort study

Abstract Background The prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in patients with coronary artery disease (CAD) with different glucose status has not been established. This study sought to evaluate the significance of NT-proBNP in predicting major adverse cardiovascular events (MACEs) in patients with chronic coronary syndrome (CCS) and normal left-ventricular systolic function (LVSF) according to different glucose status, especially in those with abnormal glucose metabolism. Methods A total of 8062 patients with CCS and normal LVSF were consecutively enrolled in this prospective study. Baseline plasma NT-proBNP levels were measured. The follow-up data of all patients were collected. Kaplan-Meier and Cox regression analyses were used to assess the risk of MACEs according to NT-proBNP tertiles stratified by glucose status. Results Over an average follow-up of 59.13 ± 18.23 months, 569 patients (7.1 %) suffered from MACEs, including cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke. Kaplan-Meier analysis showed that high NT-proBNP levels had a significant association with MACEs in subjects with prediabetes mellitus (pre-DM) or DM, but not in patients with normoglycemia. Multivariate Cox regression analysis revealed that NT-proBNP remained an independent predictor of MACEs in patients with pre-DM [hazard ratio (HR): 2.56, 95% confidence interval (CI): 1.34–4.91] or DM (HR: 2.34, 95% CI: 1.32–4.16). Moreover, adding NT-proBNP to the original Cox model including traditional risk factors significantly increased the C-statistic by 0.035 in pre-DM and DM, respectively. Conclusions The present study indicated that NT-proBNP could well predict worse outcomes in dysglycemic patients with CCS and normal LVSF, suggesting that NT-proBNP may help with risk stratification in this population.

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Can Tei index predict high syntax score in patients with chronic coronary syndrome and normal left ventricular systolic function?

Journal of Cardiovascular Echography ◽

10.4103/jcecho.jcecho_73_20 ◽

2021 ◽

Vol 31 (1) ◽

pp. 11

Author(s):

Hazem Mansour ◽

AhmedIbrahim Nassar ◽

WalaaAdel Abdel Rehim ◽

AlaaMahmoud Roushdy ◽

Mohamed Abobakr ◽

...

Keyword(s):

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Syntax Score ◽

Tei Index ◽

Ventricular Systolic Function ◽

Coronary Syndrome ◽

Normal Left Ventricular

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An Atypical Presentation of Acute Coronary Syndrome

European Cardiology Review ◽

10.15420/ecr.2012.8.1.67 ◽

2012 ◽

Vol 8 (1) ◽

pp. 67

Author(s):

Syed Khurram Mushtaq Gardezi ◽

Keyword(s):

Acute Coronary Syndrome ◽

Coronary Artery ◽

Systolic Function ◽

Artery Bypass ◽

Left Ventricular Systolic Function ◽

Regional Wall Motion ◽

Dobutamine Stress ◽

Left Ventricular ◽

Ventricular Systolic Function ◽

Coronary Syndrome

A 61-year-old man was admitted to hospital with severe occipital headache and weakness and numbness of the left arm. His electrocardiograms showed changes hinting at acute coronary syndrome (ACS). However, in view of his clinical presentation, he underwent tests for likely subarachnoid haemorrhage, but this was ruled out. The next day, he was referred to cardiology. A transthoracic echocardiogram showed reduced left ventricular systolic function along with regional wall motion abnormalities involving inferoposterior walls. The patient was treated as per the protocol for ACS. A dobutamine stress echocardiogram confirmed inferior myocardial infarction with evidence of myocardial viability in the affected left ventricular segments. Subsequent investigations confirmed three-vessel coronary artery disease and reduced left ventricular systolic function. The patient underwent successful coronary artery bypass grafting.

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Seizures and Syncope Due to Complete Atrioventricular Block in a Patient with Acute Myocarditis with a Normal Left Ventricular Systolic Function

Internal Medicine ◽

10.2169/internalmedicine.51.8410 ◽

2012 ◽

Vol 51 (21) ◽

pp. 3035-3040 ◽

Cited By ~ 4

Author(s):

Ryohei Akashi ◽

Yoshihisa Kizaki ◽

Hiroaki Kawano ◽

Yasushi Takahara ◽

Kojiro Nakao ◽

...

Keyword(s):

Atrioventricular Block ◽

Systolic Function ◽

Acute Myocarditis ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Complete Atrioventricular Block ◽

Ventricular Systolic Function ◽

Normal Left Ventricular ◽

Complete Atrioventricular

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The effect of valvular regurgitation on plasma Cardiotrophin-1 in patients with normal left ventricular systolic function

European Journal of Heart Failure ◽

10.1016/s1388-9842(00)00105-7 ◽

2000 ◽

Vol 2 (4) ◽

pp. 387-391 ◽

Cited By ~ 16

Author(s):

Suneel Talwar ◽

Iain B. Squire ◽

Joan E. Davies ◽

Leong L. Ng

Keyword(s):

Systolic Function ◽

Left Ventricular Systolic Function ◽

Left Ventricular ◽

Valvular Regurgitation ◽

Ventricular Systolic Function ◽

Normal Left Ventricular

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IMPACT OF NT-PROBNP LEVELS IN PATIENTS WITH ACUTE ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION WHO HAVE NORMAL LEFT VENTRICULAR SYSTOLIC FUNCTION WITHOUT REGIONAL WALL MOTION ABNORMALITY

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(11)61793-2 ◽

2011 ◽

Vol 57 (14) ◽

pp. E1793

Author(s):

Youngkeun Ahn ◽

Seo Na Hong ◽

Myung Ho Jeong ◽

Jeong Gwan Cho ◽

Jong Chun Park ◽

...

Keyword(s):

Wall Motion ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Regional Wall Motion ◽

Left Ventricular ◽

Ventricular Systolic Function ◽

St Segment Elevation ◽

Segment Elevation Myocardial Infarction ◽

Normal Left Ventricular ◽

St Segment

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Abstract 499: Lower Diastolic Wall Strain Is Associated With Percutaneous Coronary Intervention in Patients With Normal Left Ventricular Systolic Function

Arteriosclerosis Thrombosis and Vascular Biology ◽

10.1161/atvb.35.suppl_1.499 ◽

2015 ◽

Vol 35 (suppl_1) ◽

Author(s):

Min-Kyung Kang ◽

Soo Ho Kim ◽

Jaehuk Choi ◽

Hee-Sun Mun ◽

Seonghoon Choi ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Systolic Function ◽

Left Ventricular Systolic Function ◽

Coronary Intervention ◽

Left Ventricular ◽

Ventricular Systolic Function ◽

Normal Left Ventricular ◽

Diastolic Wall Strain ◽

Percutaneous Coronary ◽

Echocardiographic Parameters

Background: Left ventricular (LV) diastolic dysfunction occurs before LV systolic dysfunction and electrocardiographic changes in ischemic cascade. Diastolic wall strain (DWS) has been proposed as a marker of LV diastolic stiffness. Therefore, the objectives of this study were to defined the relationship between DWS and percutaneous coronary intervention (PCI) and see other echocardiographic parameters in patients who undergoing coronary angiography (CAG). Methods: 254 patients (mean age: 61 ± 10, 136 (54%) men) undergoing CAG and normal left ventricular systolic function without regional wall motion abnormalities were enrolled, and among them, 68 (27%) patients performed PCI. All patients performed echocardiography before CAG and DWS defined using posterior wall thickness (PWT) measurements from standard echocardiographic images (DWS =[PWT(systole)-PWTdiastole)]/PWT(systole)). Results: Patients who performed PCI showed significantly lower DWS (0.27 ± 0.09 vs. 0.39 ± 0.08, p < 0.001). Age did not differ between the two groups (61.6 ± 10.6 vs. 60.9 ± 10.4, p = 0.623), and LV ejection fraction was also similar (62.8 ± 4.6 vs. 63.5 ± 5.2%, p = 0.380). Other echocardiographic parameters did not show significance differences but E/E’ ratio was slightly but significantly elevated in patients performed PCI (10.9 ± 4.8 vs 9.2 ± 3.3, p = 0.011). In multiple regression analysis, lower DWS was an independent predictor for PCI (Cut-off value: 0.34, sensitivity: 89%, AUC: 0.870, SE: 0.025, p < 0.001). Conclusion: DWS, a simple parameter that can be calculated from routine 2D echocardiography, is inversely associated with presence of coronary artery disease and PCI.

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