Abstract：
UNASSIGNED: A third of all acute coronary events that present in the Australian population occur in patients with established coronary heart disease. This study assessed the prognostic value of combined B-type natriuretic peptides (BNP) measurement and quantitative myocardial perfusion scan (MPS) data for cardiac events (CE).
UNASSIGNED: This retrospective cohort study involved 133 patients from rural Western Australia. The cut-off for normality was 6.0 for qualitative summed difference scores (SDS) of MPS and 400 pg/mL for BNP.
UNASSIGNED: Patients with no CE had a mean SDS and BNP (1.52 with a 95% CI of 0.34 to 2.69), (175.9 with a 95% CI of 112.7-239.1) that was lower than patients with CE (6.54 with 95% CI 4.18-9.89) (P = 0.0003), (669.1 with 95% CI 543.9-794.3) (P < 0.0001). The sensitivity and specificity of combined testing for predicting CE respectively were 79.6% and 86.3% for SDS, 84.6% and 94.1% for BNP, and 100% and 92.7% for SDS and BNP combined.
UNASSIGNED: Elevated BNP is marginally superior to MPS in predicting CEs in patients who have previously undergone percutaneous coronary intervention (PCI); however, MPS can identify the region of myocardium most at risk. Routine BNP monitoring in this subgroup may serve as secondary prevention by identifying subclinical disease.
Rural communities are disproportionately affected by preventable coronary heart disease-related deaths and access to cardiac imaging techniques can be infrequent or unavailable.Secondary prevention strategies can reduce hospital readmissions and contribute to improving the management of chronic conditions.This study demonstrated that elevated B-type natriuretic peptides levels were marginally superior to myocardial perfusion scans in predicting cardiac events in patients with prior percutaneous coronary intervention.Monitoring BNP levels in rural patients with prior percutaneous coronary interventions is a relatively non-invasive and inexpensive, and may lead to improved risk estimation, identify the subclinical disease and provoke further investigation as clinically appropriate.
UNASSIGNED: This retrospective cohort study involved 133 patients from rural Western Australia. The cut-off for normality was 6.0 for qualitative summed difference scores (SDS) of MPS and 400 pg/mL for BNP.
UNASSIGNED: Patients with no CE had a mean SDS and BNP (1.52 with a 95% CI of 0.34 to 2.69), (175.9 with a 95% CI of 112.7-239.1) that was lower than patients with CE (6.54 with 95% CI 4.18-9.89) (P = 0.0003), (669.1 with 95% CI 543.9-794.3) (P < 0.0001). The sensitivity and specificity of combined testing for predicting CE respectively were 79.6% and 86.3% for SDS, 84.6% and 94.1% for BNP, and 100% and 92.7% for SDS and BNP combined.
UNASSIGNED: Elevated BNP is marginally superior to MPS in predicting CEs in patients who have previously undergone percutaneous coronary intervention (PCI); however, MPS can identify the region of myocardium most at risk. Routine BNP monitoring in this subgroup may serve as secondary prevention by identifying subclinical disease.
Rural communities are disproportionately affected by preventable coronary heart disease-related deaths and access to cardiac imaging techniques can be infrequent or unavailable.Secondary prevention strategies can reduce hospital readmissions and contribute to improving the management of chronic conditions.This study demonstrated that elevated B-type natriuretic peptides levels were marginally superior to myocardial perfusion scans in predicting cardiac events in patients with prior percutaneous coronary intervention.Monitoring BNP levels in rural patients with prior percutaneous coronary interventions is a relatively non-invasive and inexpensive, and may lead to improved risk estimation, identify the subclinical disease and provoke further investigation as clinically appropriate.
摘要：
简介：澳大利亚人群中所有急性冠状动脉事件的三分之一发生在已确诊的冠心病患者中。这项研究评估了B型利钠肽（BNP）测量和定量心肌灌注扫描（MPS）数据对心脏事件（CE）的预后价值。材料和方法：这项回顾性队列研究涉及来自西澳大利亚州农村的133名患者。MPS的定性求和差异评分（SDS）的正常性临界值为6.0，BNP为400pg/mL。结果：无CE患者的平均SDS和BNP（1.52，95%CI为0.34至2.69），（175.9，95%CI为112.7-239.1）低于CE患者（6.54，95%CI为4.18-9.89）（P=0.0003），（669.1，95%CI543.9-794.3）（P<0.0001）。联合检测对SDS预测CE的敏感性和特异性分别为79.6%和86.3%,BNP占84.6%和94.1%，SDS和BNP的组合为100%和92.7%。讨论与结论：在预测先前接受过经皮冠状动脉介入治疗（PCI）的患者的CEs方面，BNP升高略优于MPS；然而，MPS可以识别最危险的心肌区域。该亚组的常规BNP监测可以通过识别亚临床疾病作为二级预防。
农村社区不成比例地受到可预防的冠心病相关死亡的影响，心脏成像技术的使用可能很少或不可用。二级预防策略可以减少再次住院，并有助于改善慢性病的管理。这项研究表明，在先前经皮冠状动脉介入治疗的患者中，升高的B型利钠肽水平在预测心脏事件方面略优于心肌灌注扫描。监测农村患者既往经皮冠状动脉介入治疗的BNP水平是一种相对无创和廉价的方法，并可能导致改进的风险估计，确定亚临床疾病，并在临床上适当时引发进一步研究。
农村社区不成比例地受到可预防的冠心病相关死亡的影响，心脏成像技术的使用可能很少或不可用。二级预防策略可以减少再次住院，并有助于改善慢性病的管理。这项研究表明，在先前经皮冠状动脉介入治疗的患者中，升高的B型利钠肽水平在预测心脏事件方面略优于心肌灌注扫描。监测农村患者既往经皮冠状动脉介入治疗的BNP水平是一种相对无创和廉价的方法，并可能导致改进的风险估计，确定亚临床疾病，并在临床上适当时引发进一步研究。
