Expression characteristics and clinical significance of serum N-terminal pro-B-type natriuretic peptide, heart-type fatty acid-binding protein and cardiac troponin I in different degrees of coronary heart disease
WU Shu-zhi, CHEN Jian, QIN Wei-guo, DENG Sheng, XU Yan
Department of Clinical Laboratory, Mawangdui Hospital, the People’s Hospital of Hunan Province, Changsha, Hunan 410026, China
Abstract：Objective To explore the expression features and clinical value of serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), heart-type fatty acid-binding protein (HFABP) and cardiac troponin I(cTnI)in various degrees of coronary heart disease (CHD). Methods Five hundred and eighty-two patients with CHD were classified into the silent myocardial ischemiapectoris (SMI) group (n=142), stable angina pectoris (SAP) group (n=151), unstable angina pectoris(UAP)group (n=155) and acute myocardial infarction (AMI) group (n=134) according to the severe degree of CHD. The serum NT-proBNP, H-FABP and cTnI levels of 582 CHD patients and 80 healthy controls were measured by bi-directional lateral flow immunoassay, and the results were statistically analyzed. Results The serum NT-proBNP levels in the patients with various degrees of CHD were significantly higher than that in the healthy controls (P<0.01). The serum level and positive rate of NT-proBNP were increased with the increase of severe degree of CHD, with statistically significant differences among different CHD groups (P<0.01). The serum levels and positive rates of HFABP and cTnI in the AMI group were significantly higher than those in the UAP group (P<0.01), while those in the UAP group were significantly higher than those in the SAP group (P<0.01). No statistically significant differences were found in the serum levels of HFABP and cTnI between the healthy control group and the SAP group, the SMI group (P>0.05). The positive rates of HFABP and cTnI in the SAP group and the SMI group were both zero. The positive rates of NT-proBNP in the SAP group and the SMI group were both significantly higher than those of HFABP and cTnI (P<0.01). The positive rates of NT-proBNP and HFABP in the UAP group were significantly higher than that of cTnI (P<0.01). The ROC curve indicated that the optimal cut-off values of serum NT-proBNP levels for diagnosis of SMI and SAP were 317.23 ng/L and 725.40 ng/L respectively, the optimal cut-off values of serum NT-proBNP, HFABP and cTnI levels for diagnosis of UAP and AMI were 2,125.40 ng/L, 7.86 ng/L, 0.085 ng/L and 3,984.21 ng/L, 14.75 ng/L, 1.98 ng/L respectively. Conclusions There are different expression characteristics of H-FABP, NT-proBNP and cTnI in various degrees of CHD. Combined detection of serum HFABP, NT-proBNP and H-FABP levels is of great clinical value for diagnosis and classification of different degrees of CHD.
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2016, Vol. 23 
