Open AccessAngiopoietin‐2 provides no incremental predictive value for the presence of obstructive coronary artery disease over N‐terminal pro‐brain natriuretic peptide
Author(s) -
Jian Wen,
Mo ChangHua,
Yang GuoLiang,
Li Lang,
Gui Chun
Publication year - 2019
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22972
Subject(s) - medicine , cardiology , coronary artery disease , stenosis , cardiac catheterization , circumflex , natriuretic peptide , brain natriuretic peptide , artery , logistic regression , heart failure
Background Using circulating biomarkers as a noninvasive method to assist the evaluation of coronary artery disease (CAD) is beneficial for reducing the unnecessary diagnostic cardiac catheterization. This study aimed to assess the predictive role of angiopoietin‐2 (Ang‐2) for the presence of obstructive coronary stenosis as compared with N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) in patients with symptoms of CAD. Methods The study enrolled 222 consecutive symptomatic patients who underwent elective diagnostic cardiac catheterization from July to December 2018. Blood samples were collected in the first morning after admission. The severity of coronary stenosis was assessed by coronary angiography. The obstructive CAD was defined as stenosis ≥50% of the left main coronary artery or stenosis ≥70% of a major epicardial vessel (left anterior descending artery, left circumflex artery and right coronary artery). Results Patients with obstructive CAD (n = 120) had significantly higher levels of Ang‐2 and NT‐proBNP compared with those without. In multivariable regression analysis, only NT‐proBNP levels were independently associated with Ang‐2 levels. NT‐proBNP was superior to Ang‐2 as a predictor for the presence of obstructive CAD (NT‐proBNP, area under curve [AUC] = 0.733, vs Ang‐2, AUC = 0.626, P = 0.004). In multiple logistic regression analysis, NT‐proBNP, but not Ang‐2, was the independent predictor of obstructive CAD. The combination of Ang‐2 with NT‐proBNP did not provide the incremental value over NT‐proBNP alone. Conclusion Serum Ang‐2 levels are associated with NT‐proBNP levels in patients suspected for CAD. NT‐proBNP is superior to Ang‐2 as a predictor for the presence of obstructive CAD. However, Ang‐2 does not further increase diagnostic accuracy on top of NT‐proBNP.