130 - NT-pro BNP e angina instabile
Rivista: RIMeL - IJLaM, Vol. 1, N. 2, 2005 (MAF Servizi srl ed.)
M. Lotzniker, N. Covini, G. Re, S. Finazzi, C. Inserra, R. Pacifici, P.G. Zuccaro
Nt-pro BNP in unstable coronary artery disease.Introduction. The natriuretic peptides and, more recently, the
N-terminal fragment of Brain Natriuretic Peptide (NTproBNP)
caused great interest both in monitoring cardiac
insufficiency and in the risk stratification in acute coronary
disease. Anyway, the knowledge of the mechanism of
natriuretic peptides synthesis, release and regulation is still
incomplete. Besides myocardial necrosis any inflammatory
state may be considered a possible factor inducing their
increase.
Materials and methods. In order to pointout the importance
of these two factors, besides NT-proBNP, Troponin T,
PCR and cytokines (IL1b, IL6, IL10, IL18, IL1Ra) were
tested in 58 patients with unstable angina when entering
the coronary unit.
Results. NT-proBNP reveals a positive correlation with
proinflammatory cytokines IL6 and IL18 and a negative
one with IL1b and IL10. In case of necrosis NT-proBNP
and IL6 medians reveal a significant increase; on the contrary
IL10 medians reveal a decrease. The severity of the
coronary disease valued according to the mono/plurivessel
affection is characterised by an increase of NT-proBNP
with a reduced concentration of IL1b.
Conclusions. In unstable angina NT-proBNP represents an
efficacious global marker of the damage caused by ischemia
because of the several activation mechanisms involved. NTproBNP
and cytokines reveal a dynamic and different
relations, showing that natriuretic peptides have a
immunomodulant role in addition to the better known
cardiovascular effects.