Relation of coronary atherosclerosis determined by electron beam computed tomography and plasma levels of N-terminal pro-brain natriuretic peptide in a multiethnic population-based sample (The Dallas Heart Study)

Shuaib M Abdullah, Amit Khera, Sandeep R Das, Harold G. Stanek, Russell M. Canham, Anne K. Chung, David A. Morrow, Mark H Drazner, Darren K McGuire, James A de Lemos

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Abstract

Elevated plasma levels of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are seen in the setting of cardiac ischemia and are associated with adverse outcomes in patients with coronary artery disease. The mechanisms leading to natriuretic peptide elevation in patients with coronary artery disease, including the contribution of coronary atherosclerosis itself, have not been fully elucidated. Measurement of NT-pro-BNP, electron beam computed tomography, and cardiac magnetic resonance imaging were performed in 2,445 subjects from the Dallas Heart Study who were free of heart failure and renal insufficiency. Electron beam computed tomography-determined coronary artery calcium scores were categorized as none (<10), mild (<10 to <100), moderate (<100 to <400), and severe (<400). NT-pro-BNP levels increased significantly across increasing coronary artery calcium score categories (p <0.0001 for trend). In multivariate models adjusted for age, gender, race, body mass index, hypertension, history of myocardial infarction, angina, angiotensin-converting enzyme inhibitor use, β-blocker use, left ventricular (LV) ejection fraction, and LV mass, higher coronary artery calcium scores remained independently associated with higher log NT-pro-BNP levels (p = 0.03). This association persisted in similar models excluding patients with low LV ejection fractions, LV hypertrophy, angina pectoris, and a history of myocardial infarction. In conclusion, these findings support the hypothesis that coronary atherosclerosis may directly influence the activation of the cardiac neurohormonal system.

Original languageEnglish (US)
Pages (from-to)1284-1289
Number of pages6
JournalAmerican Journal of Cardiology
Volume96
Issue number9
DOIs
StatePublished - Nov 1 2005

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X Ray Computed Tomography
Brain Natriuretic Peptide
Coronary Artery Disease
Coronary Vessels
Calcium
Stroke Volume
Population
Myocardial Infarction
Natriuretic Peptides
Angina Pectoris
Left Ventricular Hypertrophy
Angiotensin-Converting Enzyme Inhibitors
Renal Insufficiency
Body Mass Index
Ischemia
Heart Failure
Magnetic Resonance Imaging
Hypertension
pro-brain natriuretic peptide (1-76)

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Relation of coronary atherosclerosis determined by electron beam computed tomography and plasma levels of N-terminal pro-brain natriuretic peptide in a multiethnic population-based sample (The Dallas Heart Study)",
abstract = "Elevated plasma levels of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are seen in the setting of cardiac ischemia and are associated with adverse outcomes in patients with coronary artery disease. The mechanisms leading to natriuretic peptide elevation in patients with coronary artery disease, including the contribution of coronary atherosclerosis itself, have not been fully elucidated. Measurement of NT-pro-BNP, electron beam computed tomography, and cardiac magnetic resonance imaging were performed in 2,445 subjects from the Dallas Heart Study who were free of heart failure and renal insufficiency. Electron beam computed tomography-determined coronary artery calcium scores were categorized as none (<10), mild (<10 to <100), moderate (<100 to <400), and severe (<400). NT-pro-BNP levels increased significantly across increasing coronary artery calcium score categories (p <0.0001 for trend). In multivariate models adjusted for age, gender, race, body mass index, hypertension, history of myocardial infarction, angina, angiotensin-converting enzyme inhibitor use, β-blocker use, left ventricular (LV) ejection fraction, and LV mass, higher coronary artery calcium scores remained independently associated with higher log NT-pro-BNP levels (p = 0.03). This association persisted in similar models excluding patients with low LV ejection fractions, LV hypertrophy, angina pectoris, and a history of myocardial infarction. In conclusion, these findings support the hypothesis that coronary atherosclerosis may directly influence the activation of the cardiac neurohormonal system.",
author = "Abdullah, {Shuaib M} and Amit Khera and Das, {Sandeep R} and Stanek, {Harold G.} and Canham, {Russell M.} and Chung, {Anne K.} and Morrow, {David A.} and Drazner, {Mark H} and McGuire, {Darren K} and {de Lemos}, {James A}",
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AU - Abdullah, Shuaib M

AU - Khera, Amit

AU - Das, Sandeep R

AU - Stanek, Harold G.

AU - Canham, Russell M.

AU - Chung, Anne K.

AU - Morrow, David A.

AU - Drazner, Mark H

AU - McGuire, Darren K

AU - de Lemos, James A

PY - 2005/11/1

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N2 - Elevated plasma levels of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are seen in the setting of cardiac ischemia and are associated with adverse outcomes in patients with coronary artery disease. The mechanisms leading to natriuretic peptide elevation in patients with coronary artery disease, including the contribution of coronary atherosclerosis itself, have not been fully elucidated. Measurement of NT-pro-BNP, electron beam computed tomography, and cardiac magnetic resonance imaging were performed in 2,445 subjects from the Dallas Heart Study who were free of heart failure and renal insufficiency. Electron beam computed tomography-determined coronary artery calcium scores were categorized as none (<10), mild (<10 to <100), moderate (<100 to <400), and severe (<400). NT-pro-BNP levels increased significantly across increasing coronary artery calcium score categories (p <0.0001 for trend). In multivariate models adjusted for age, gender, race, body mass index, hypertension, history of myocardial infarction, angina, angiotensin-converting enzyme inhibitor use, β-blocker use, left ventricular (LV) ejection fraction, and LV mass, higher coronary artery calcium scores remained independently associated with higher log NT-pro-BNP levels (p = 0.03). This association persisted in similar models excluding patients with low LV ejection fractions, LV hypertrophy, angina pectoris, and a history of myocardial infarction. In conclusion, these findings support the hypothesis that coronary atherosclerosis may directly influence the activation of the cardiac neurohormonal system.

AB - Elevated plasma levels of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are seen in the setting of cardiac ischemia and are associated with adverse outcomes in patients with coronary artery disease. The mechanisms leading to natriuretic peptide elevation in patients with coronary artery disease, including the contribution of coronary atherosclerosis itself, have not been fully elucidated. Measurement of NT-pro-BNP, electron beam computed tomography, and cardiac magnetic resonance imaging were performed in 2,445 subjects from the Dallas Heart Study who were free of heart failure and renal insufficiency. Electron beam computed tomography-determined coronary artery calcium scores were categorized as none (<10), mild (<10 to <100), moderate (<100 to <400), and severe (<400). NT-pro-BNP levels increased significantly across increasing coronary artery calcium score categories (p <0.0001 for trend). In multivariate models adjusted for age, gender, race, body mass index, hypertension, history of myocardial infarction, angina, angiotensin-converting enzyme inhibitor use, β-blocker use, left ventricular (LV) ejection fraction, and LV mass, higher coronary artery calcium scores remained independently associated with higher log NT-pro-BNP levels (p = 0.03). This association persisted in similar models excluding patients with low LV ejection fractions, LV hypertrophy, angina pectoris, and a history of myocardial infarction. In conclusion, these findings support the hypothesis that coronary atherosclerosis may directly influence the activation of the cardiac neurohormonal system.

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