N-terminal proatrial natriuretic peptide in angina pectoris: impact of revascularization by angioplasty

Aims. We investigated whether levels of N-terminal proatrial natriuretic pe ptide (N-terminal proANP) reflect the severity of coronary artery disease i n chronic, stable angina pectoris. Furthermore, we investigated if revascul arization by percutaneous transluminal coronary angioplasty (PTCA) affected the N-terminal proANP level and, finally, whether restenosis could be pred icted by changes in N-terminal proANP after PTCA. Methods and results. N-terminal proANP was measured in 286 patients before and after PTCA. The patients' baseline level of N-terminal proANP (787+/-40 3 pmol/l) correlated significantly with left ventricular end diastolic pres sure, age and serum creatinine, but not with the number of stenotic vessels . Twenty-four hours post-PTCA N-terminal proANP decreased significantly, an d completely revascularized patients demonstrated a decline two-fold larger than those incompletely revascularized (Delta N-terminal proANP -114+/-178 vs. -53+/-231 pmol/l, P<0.05). After 14 days N-terminal proANP had returne d to baseline in both groups. Changes in N-terminal proANP from post-PTCA t o the final follow-up was not predictive of angiographic restenosis. Interpretation. The significant decrease in N-terminal proANP observed afte r angioplasty, most pronounced in patients completely revascularized, is th ought to reflect a transient improvement in resting left ventricular functi on. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.