Changes Of B-type Natriuretic Peptide, D-dimer In Plasma Levels Of The Elderly Patients With Coronary Heart Disease

Objectives To explore the changes of plasma levels of B-type natriureticpeptide(BNP)and d-dimer(D-D) in the different clinical types elderly patients withcoronary heart disease(CHD) and the correlation with LVEF. To investigate thecorrelation of the plasma BNP and D-D levels with major adverse clinical eventsoutside the hospital.Methods1. All cases were sampled from the Hospital from September2009to march2011in the senium department of cardiology，they are older than75years old.The totalof156elderly patients with CHD by clinical types were enrolled, include: acutemyocardial infarction (AMI) group of52cases, unstable angina (UAP) group of56cases, stable angina (SAP) group of48cases. Normal physical examination in30patients over the same period as the control group. To statistics the date of BNP、D-D、hs-CRP、LVEF、TCH、TG、HDL-C、LDL-C of each group and comparing the differenceand correlation of among groups.2. According to the results of blood and their pathogenetic condition, they were dividedinto four groups：the pure CHD group，the merger EH group，the merger T2DM group，and the merger EH、T2DM group. Analyzed the dates among groups.3.The total of156elderly patients with CHD were followed up outpatient service and(or) telephone access regularly. Subjects were the Drug treatment and incidence of major adverse clinical events and compared.Results1.Plasma levels of BNP, D-D, hs-CRP in AMI group were significantly higherthan those in UAP group(P<0.05),the levels in UAP group were significantly higherthan those in SAP and control group (P<0.05),and there was no significant differencesof these markers between SAP group and control group(P>0.05). Plasma BNP levelswere positively correlated with D-D and hs-CRP levels and negatively correlated withLVEF.2.Compared with the pure CHD group，the other three groups had significantly higherBNP、D-D、hs-CRP and lower LVEF(P<0.05), but compared with CHD with EH andT2DM group, other groups had lower BNP、D-D、hs-CRP and higher LVEF (p<0.05);There was no differences between patients complicating type T2DM and patientscomplicating EH.These four groups were commom in TCH、TG、HDL-C、LDL-C.3. Compared with the four levels of BNP and the other three groups hadsignificantly(P<0.05). Compared with the three levels of BNP and the one、two levels ofBNP had significantly(P<0.05). With the increase of the levels of BNP,the LVEFgradually reduced.4. The numbers of adverse clinical events in the elevated individual of BNP, D-D washigher than the individual of normal(P<0.05). Compared with the B group,C group,Dgroup and A group had significantly higher(P<0.05). There was no differences betweenthe B group and C group (P>0.05).Conclusions1.Plasma levels of BNP gradually increase in SAP、UAP、AMI groups,The levels may reflect the degree of myocardial ischemia,The ranges of the increased is correlated to pathological changes degree. Plasma levels of BNP had differences in thepatients of elderly patients with CHD With or no complications, The CHD with EH andT2DM group is highest,The result showed the lesions degree and the risk stratificationin the elderly patients with CHD is correlated to levels of BNP.2. Combined testing the levels of BNP、D-D have more convenient clinical value in theprognostic of high-risk groups of elderly patients with CHD.