The following is a summary of “N terminal pro-brain natriuretic peptide level and benefits of chronic total occlusion revascularization,” published in the May 2024 issue of Cardiology by Gold et al.
The vagueness over revascularizing chronic total occlusions (CTOs) benefiting patients’ survival is still unclear.
Researchers conducted a retrospective study to investigate whether patients with CTO have higher N terminal pro-brain natriuretic peptide (NT pro-BNP) levels, whether these levels predict AEs, and whether elevated levels benefit revascularization.
They analyzed 392 patients with stable coronary artery disease (CAD) and CTO getting coronary angiography, analysis was done for rates of all-cause mortality, cardiovascular death, and a composite of cardiovascular death, myocardial infarction, and heart failure (HF) hospitalizations. The Cox proportional and Fine and Gray models were used to link NT pro-BNP levels with event rates in patients with CTO.
The results showed that NT pro-BNP levels were higher in patients with CTO (median 230.0 vs. 177.7 pg/mL, P ≤0.001). Doubling NT pro-BNP in patients with CTO increased AEs rates by >25%. Around 28.5% (n=111) underwent CTO revascularization. With elevated NT pro-BNP (>125 pg/mL), those who had CTO revascularization had lower event rates (adjusted cardiovascular death HR 0.29, 95% CI (0.09–0.88)). Event rates were similar with or without revascularization for patients with low NT pro-BNP levels (≤125 pg/mL).
Investigators concluded that NT pro-BNP levels could indicate who might benefit from CTO revascularization.
Source: internationaljournalofcardiology.com/article/S0167-5273(24)00818-0/abstract