Journal of Life Science (생명과학회지)

Korean Society of Life Science (한국생명과학회)
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Relationship and Clinical Usefulness between Preoperative Levels of Brain Natriuretic Peptide, Other Cardiac Markers and Perioperative Parameters in Patients with Coronary Artery Disease

관상동맥질환자에 있어 수술 전 brain natriuretic peptide 농도, 심장표지자, 수술전후기 변수들 간의 상관관계와 임상적 유용성

  • Choi, Seok-Cheol (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Kim, Yang-Weon (Department of Emergency Medicine, Inje University Busan Paik Hospital) ;
  • Hyun, Kyung-Yae (Department of Clinical Laboratory Science, College of Natural Sciences, Dong-Eui University) ;
  • Hwang, Soo-Myung (Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan) ;
  • Moon, Seong-Min (Biomedical Laboratory of Science, Department of Smart Foods and Drugs, Inje University)
  • 최석철 (부산가톨릭대학교 보건과학대학 임상병리학과) ;
  • 김양원 (인제대학교 의과대학 부산백병원 응급의학과) ;
  • 현경예 (동의대학교 자연과학대학 임상병리학과) ;
  • 황수명 (부산가톨릭대학교 보건과학대학 임상병리학과) ;
  • 문성민 (인제대학교 식의학생명공학대학 임상병리학과)
  • Received : 2010.07.13
  • Accepted : 2010.09.13
  • Published : 2010.09.30
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Abstract

Cardiac troponin-I (cTnI), creatine kinase-MB (CK-MB), and C-reactive protein (CRP) are routine cardiac markers for the diagnosis of cardiovascular disease. Recently, brain natriuretic peptide (BNP) has garnered attention as a marker of heart failure. This study was retrospectively designed to investigate the relationships between preoperative BNP, other cardiac markers levels and perioperative parameters in seventy-four adult patients that underwent off-pump coronary artery bypass grafting (OPCAB) and to assess its usefulness for predicting postoperative outcomes. Preoperative levels of BNP, cTnI, CK-MB, and CRP had significantly positive or negative correlations with echocadiographic parameters. There were significantly positive relationships between BNP, cTnI, CK-MB, and CRP concentration. Postoperative mechanical ventilation time had a positive correlation to preoperative levels of cTnI, CK-MB, and CRP, while ICU-staying period had a positive correlation with BNP, cTnI and CK-MB. These results reveal that a preoperative level of BNP is a good predictor and that its combination with cTnI, CK-MB, and CRP might be useful for diagnosis and comprehensive risk stratification of patients with coronary heart diseases, as well as prognosis of perioperative outcomes in OPCAB patients.

심혈관질환 진단을 위해 여러 가지 표지자들이 이용되고 있으며 그와 같은 표지자로 cardiac troponin-I (cTNI), creatine kinase-MB (CK-MB), C-reative protein (CRP)이 있다. 최근, 심장기능부전의 표지자로서 brain natriuretic peptide (BNP)에 대한 관심이 집중되고 있다. 이 연구는 심폐바이패스(cardiopulmonary bypass) 비적용 관상동맥우회수술을 시행한 74명의 성인환자를 대상으로 수술 전 BNP 농도와 다른 심장 표지자들 농도, 그리고 수술 전후 표지자들 간의 상관관계를 규명하기 위해 시행하였다. 수술 전 시기의 BNP, cTNI, CK-MB, CRP 각각의 농도는 수술 전 심초음파 변수와 양 또는 음의 상관성을 보였다. 수술 전 BNP 농도와 수술 전 cTNI, CK-MB, CRP 농도 각각과 높은 양의 상관관계가 있었다. 수술 전 BNP, cTNI, CK-MB, CRP 농도 각각은 수술 후 기계호흡보조시간, 중환자실치료기간과 유의한 양의 상관관계를 보였다. 이 연구의 결과들은 수술 전 BNP, cTNI, CK-MB, CR과 같은 심장 표지자들의 측정 및 병용은 심혈관질환자들의 진단, 환자들의 등급화, 수술 후 예후평가에 매우 유용한 방법임을 시사하고 있다.

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References

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