摘要
目的初步探讨老年稳定性冠心病(SCAD)患者静脉血浆B型利钠肽(B-type natriuretic peptide,BNP)水平在药物洗脱支架(DES)植入后的变化以及BNP水平与心血管事件的关系。方法研究入选了88例老年SCAD患者,均经冠脉造影(CAG)证实。收集临床、CAG和经皮冠脉介入(PCI)资料。所有入选者微粒子酶免分析法(化学发光法)测定静脉血浆BNP浓度。其中29例在DES植入后进行了CAG复查和BNP测定。随访1年时的死亡、非致死性急性冠脉综合征(ACS)、再次PCI、再次心血管原因入院等主要不良心血管事件。结果DES植入8月后BNP水平明显降低(P<0.05)。平均随访12.5月,BNP高水平组死亡、非致死性ACS、再入院和再次PCI联合终点发生率高于低水平组(P=0.003)。结论老年SCAD患者DES植入8月后BNP水平明显降低,可能反映了心功能的改善;基线BNP水平对SCAD 1年时发生主要不良心血管事件可能有重要预测价值。
Objective To observe the changes of brain natriuretic peptide（BNP） levels after drug-eluting stent（DES） implantation and to explore the effects of BNP levels on cardiovascular events in elderly patients with stable coronary artery disease（CAD）.Methods Between 2007 and 2009,we conducted a cohort study involving 88 old patients with stable CAD.All were confirmed by coronary angiography（CAG）.The data of clinical characteristics,CAG and percutaneous coronary intervention（PCI） were collected.Baseline samples for BNP measurement（microparticle enzyme immunoassay for BNP） were available in total patients.After DES implantation,29 old patients with stable CAD underwent the measurement of BNP again.The subjects were divided into two groups according to the baseline level of plasma BNP,such cardiovascular events as death,nonfatal ACS,repeated PCI and rehospitalization were recorded.Results BNP levels in 29 patients after PCI were significantly decreased（from 230.43±48.81 to 149.33±17.49 pg/ml,P=0.0382）.After 12.5 months follow-up,higher baseline BNP levels were associated with significantly increased risk of death,nonfatal ACS,repeated PCI and rehospitalization（P〈0.01）.Conclusions This study confirms that removal of fixed stenosis after PCI decreases the plasma level of BNP.Baseline elevated BNP concentrations are predictive of adverse cardiovascular events by 1 year after DES implantation in old patients with stable CAD.
出处
《实用老年医学》
CAS
2010年第1期33-36,共4页
Practical Geriatrics
关键词
冠心病
利钠肽
冠脉造影
药物洗脱支架
coronary artery disease
natriuretic peptide
coronary angiography
drug-eluting stent
