The effect of myocardial revascularization by means of percutaneous transluminal coronary angioplasty on plasma NT-proBNP concentration in patients with and without primary arterial hypertension

Abstract

Background Increased plasma concentrations of B-type natriuretic peptide (BNP) and N-Terminal pro-Brain Natriuretic Peptide (NT-proBNP) are sensitive biochemical markers of ventricular dysfunction. Furthermore, it has recently been shown the peptides to be increased in patients presenting with acute coronary syndromes. Although a majority of these patients as well as stable ischemic heart disease patients undergo percutaneous coronary intervention, there are few data about the effect of percutaneous transluminal coronary angioplasty (PTCA) on plasma NT-proBNP concentration. The aim of the study was to assess the effect of myocardial revascularization by means of PTCA on plasma NT-proBNP concentration in patients with and without primary arterial hypertension (HA).
Material and methods 80 patients divided into 3 groups were studied: I group: 30 patients with ischemic heart disease (IHD), confirmed during coronarography (CA), and with essential HA, who had recently undergone PTCA, II group: 30 patients with IHD, confirmed during CA, but without HA, who had recently undergone PTCA, III group: 20 patients with HA but free of IHD, confirmed during CA. The groups were similar with regard to age and body mass index. Blood samples were collected twice: 24 hours before and 24 hours after PTCA or CA. For plasma NT-proBNP measurements the electrochemiluminescence immunoassay was used (Elecsys, Roche Diagnostics).
Results The plasma NT-proBNP concentrations increased significantly after PTCA both in the group of patients with HA (193.3 ± 168.4 pg/ml vs. 289.8 ± 358.6 pg/ml; p < 0.05), and without HA (165.7 ± 101.2 pg/ml vs. 207.9 ± 152.1 pg/ml; p < 0.05). There was no significant difference in plasma NT-proBNP concentration after CA in the control group. There were no significant differences in the change in plasma NT-proBNP concentration after PTCA in patients with and without HA. The relative change in plasma NT-proBNP concentration after PTCA showed a similar pattern.
Conclusions Successful myocardial revascularization by means of PTCA results in rise in plasma NT-proBNP concentration. This effect is not related to CA. The presence of hypertensive disease does not affect on NT-proBNP concentration after PTCA. It seems that the presence of hypertension does not increase also impairement of left ventricul hemodynamic parameters leading to increase of NT-proBNP concentration immediately after PTCA.