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European Heart Journal 2004 25(9):759-764; doi:10.1016/j.ehj.2004.02.009
Copyright © 2004 by the European Society of Cardiology.
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Clinical research

Coronary angiography transiently increases plasma pro-B-type natriuretic peptide

Jens Peter Goetzea,b,*, Wang Yongzhonga, Jens F Rehfeldb, Erik Jørgensena and Jens Kastrupa

a Medical Department B, Cardiac Catheterisation Laboratory, Rigshospitalet, University of Copenhagen, 9 Blegdamsvej, 2100 Copenhagen, Denmark
b Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark

Received June 3, 2003; revised February 2, 2004; accepted February 5, 2004 * Corresponding author. Tel.: +45-3545-8323; fax: +45-3545-4640
E-mail address: jpg{at}dadlnet.dk

Aims Increased plasma concentrations of B-type natriuretic peptide (BNP) and its precursor (proBNP) provide important prognostic information in patients presenting with acute coronary syndromes. Although a majority of these patients undergo early invasive assessment, the effects of coronary angiography per se on plasma BNP and proBNP concentrations are not known. We therefore sought to determine whether coronary angiography and ventriculography affect the cardiac secretion of these prognostic markers.

Methods and results Blood samples were collected before and two minutes after coronary angiography and ventriculography in patients with or without coronary artery disease (CAD) and normal left ventricular ejection fraction. In patients with suspected CAD and normal left ventricular ejection fraction, the plasma proBNP concentration transiently increased from 11 pmol/l (range 1–67 pmol/l) to 19 pmol/l (range 5–102 pmol/l, ) two minutes after coronary angiography and ventriculography. The increase was similar in patients with or without CAD, although patients with stable CAD displayed higher plasma BNP and proBNP concentrations at baseline. In contrast, plasma BNP concentrations did not change after coronary angiography and ventriculography.

Conclusion Coronary angiography induces a transient increase in cardiac proBNP secretion. Blood sampling for plasma proBNP measurements in patient stratification and prognosis estimation should consequently be avoided immediately after coronary angiography.

Key Words: Angiography • BNP • Coronary disease • Heart failure • Natriuretic peptide • proBNP


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