The Association Between N-terminal Pro-brain Natriuretic Peptide (NT-proBNP), Fasting Blood Glucose (FBG), Highsensitive C-reactive Protein (HsCRP) And Leptin In Patient With Acute Coronary Syndorme (ACS)

Object:This study addressed to measure serum N-terminal pro-brain natriuretic peptide (NT-proBNP), fasting blood glucose(FBG), highsensitive c-reactive protein(HsCRP) and leptin concentration in Patients with acute coronary syndorme, stable angina pectoris and normal healthy subjects, and aims to investigate the correlation between them, and the clinical significance.Methods:one hundred and twenty subjects were divided into four groups:30 patients with acute myocardial infarction,30 patients with unstable angina pectoris,30 patients with stable angina pectoris and 30 normal healthy subjects who were matched with age and sex as control. NT-proBNP, FBG, HsCRP and leptin s concentration were determined by Biochemistry Laboratory, all the subjects were performed to detect left ventricular ejection fraction, left ventricular diastolic diameter by echocardiography. According to the levels of the NT-proBNP concentration, ACS patients were divided into two groups to observe the relationship between the levels of the NT-proBNP and prognosis. All data was analyzed with SPSS17.0 statistical software, numerical data was reported as the median value standard deviation, signicant test uses t test, correlation test uses multi-variate/stepwise regression analysis, probability value was considered significant when<0.05.Results:1 The serum level of NT-proBNP was higher in AMI patients than those of UAP, and AP, and contral subjects(p=0.025, p=0.000, p=0.000). The serum level of NT-proBNP in UAP patients was higher than AP, contral subjects(p=0.029, p=0.008). AP patients'level was higher than normal healthy subjects(p=0.000).2 Compared with AMI patients, the level of HsCRP in UAP patients has no significant difference(p=0.869), but the level of HsCRP in AMI and UAP patients was increased than AP and normal subjects(p=0.000, p=0.000), the level of HsCRP in AP and normal patients has no significant difference, too(p=0.660).3 The serum level of FBG was higher in AMI patients than those of UAP, and AP, and contra] subjects(p=0.049, p=0.000, p=0.000). The serum level of FBG in UAP patients was higher than AP, contral subjects(p=0.001, p=0.003), the level of FBG in AP and normal patients has no significant difference(p=0.389).4 Compared with AMI patients, the level of leptin in UAP patients has no significant difference(p=0.105). but the level of leptin in AMI patients was increased than AP and normal subjects(p=0.000, p=0.001), The serum level of leptin in UAP patients was higher than AP, contral subjects(p=0.041, p=0.000), the level of leptin in AP and normal patients has also significant difference(p=0.000).5 Compared with AMI patients, the volume of LVDD in UAP patients has no significant difference(p=0.189), but volume of LVDD in AMI patients was higher than AP and normal subjects(p=0.017, p=0.000), the volume of LVDD in AP and normal patients has also significant difference(p=0.000).6 the level of LVEF in AMI and UAP has no significant difference (p=0.104), but the level of LVEF in AMI and UAP patients was decreased than AP and normal subjects(p=0.000, p=0.000), the level of LVEF in AP and normal patients has also significant difference, too(p=0.000).7 The incidence of MACE in the group(NT-proBNP≥1000pg/ml)was significantly higher than group(NT-proBNP<1000pg/m) (P>0.001)。8 In the ACS patients, the level of NT-proBNP were negative correlated with LVEF (r=-0.706 p=0.000), were positive correlated with FBG, LVDD, HsCRP (r=0.391 p=0.002,r=0.667p=0.000,r=0.511 p=0.000), and have no correlation about leptin (r=0.035 p=0.791), after multi-variate/stepwise regression analysis, LVEF, LVDD, HsCRP were significantly correlated with NT-proBNP.9 In the ACS patients, the level of HsCRP were positive correlated with LVDD, FBG, NT-proBNP(r=0.667 p=0.000, r=0.308 p=0.017, r=0.511 p=0.000), were negative correlated with LVEF(r=-0.472 p=0.000), and have no correlation about leptin(r=0.069 p=0.600), after multi-variate/stepwise regression analysis, HsCRP were positive and significantly correlated with NT-proBNP.10 In the ACS patients, the level of FBG were positive correlated with HsCRP, NT-proBNP,Leptin and LVEF(r=0.308p=0.017,r=0.391 p=0.002, r=0.318p=0.013), were negative correlated with LVEF (r=-0.321 p=0.012), and have no correlation about LVDD(r=0.246 p=0.058), after multi-variate/stepwise regression analysis, FBG were positive and significantly correlated with NT-proBNP, Leptin.11 In the ACS patients, the volume of LVDD were negative and significantly correlated with LVEF(r=-0.759 p=0.000).Conclusion:1 In the early stage of the ACS patients followed by the elevated levels of NT-proBNP, HsCRP, FBG, and Leptin.2 ACS patients associated with ventricular remodeling, LVDD increasing and LVEF decreasing, frequently.3The levels of NT-proBNP is a sensitive indicator to determine prognosis of patients with ACS patients.4 After multi-variate/stepwise regression analysis in ACS patients, the level of NT-proBNP were negative correlated with LVEF, were positive correlated with LVDD and HsCRP, HsCRP were positive and significantly correlated with NT-proBNP, FBG were positive and significantly correlated with NT-proBNP and Leptin, and LVDD were negative and significantly correlated with LVEF.