Changes in N-terminal Pro B-type Natriuretic Peptide Concentration: Comparative Study of Percutaneous Transluminal Coronary Angioplasty and Off-Pump Coronary Artery Bypass Graft

The goal of this study was to compare the effects of different reperfusion methods on N-terminal B-type natriuretic peptide (NT-proBNP) in percutaneous transluminal coronary angioplasty (PTCA) or off-pump coronary artery bypass (OPCAB) patients. Fifty subjects were enrolled in the study, 32 patients received PTCA and 18 OPCAB. An NT-proBNP measurement was performed before intervention and at 1, 3, and 7 days after the procedures. NT-proBNP levels were not significantly different before intervention (PTCA group 297±147.3 vs. OPCAB group 235±167.8 pg/mL, p>0.05). However, 1 day after the procedures, NT-proBNP levels were higher in the OPCAB group (PTCA 375±256.4 vs. OPCAB 1,415±737.6 pg/mL, p<0.05), after 3 days NT-proBNP reached peak levels (PTCA 480±363.0 vs. OPCAB 2,119±818.4 pg/mL, p<0.05), and levels were reduced after 7 days (PTCA 292±243.7 vs. OPCAB 522±334.0 pg/mL, p>0.05). PTCA induced a mild and transient increase in NT-proBNP concentration, but OPCAB caused sustained high NT-proBNP levels during the 7 day postoperatively. However, differences between NT-proBNP levels associated with these two modalities showed a tendency to decrease rapidly postoperatively.