الفهرس 
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Abstract
SUMMARY
cute coronary syndromes without ST elevation encompass
a wide range of events and have different prognostic
values in relation to the type of plaque lesions and the diffusion
of coronary atherosclerosis. The risk assessment, based on
clinical history and examination, electrocardiographic (ECG)
characteristics, and markers of myocardial damage, still
remains relatively inaccurate.
The risks of subsequent death and/or recurrent
ischemic events also vary widely, depending on the presence of
myocardial ischemic areas, irreversible myocyte injury, the
hemodynamic consequences of ischemia and the extent of
coronary atherosclerosis.
B-type natriuretic peptide (BNP) is a peptide consisting
of 32 amino acids produced by the myocytes as a prohormone.
It is released in response to ventricular dilatation and pressure
overload, in its active form after peptidase degradation, into the
cardiovascular system.
This study was carried out in the cardiology department
of Ain Shams University Hospitals from January to July 2015
to find the relation between the BNP level and severity of
coronary artery disease as assessed by Gensini score in patients
who presented with unstable angina and non ST elevation
myocardial infarction
This study included 90 patients who were admitted with
diagnosis NSTE-ACS and underwent coronary angiography.
We found Patients’ age was ranging from 39 years to 73
years with a mean and SD was 57.16 ± 7.90, of this population
56.7% (51) were males and 43.3% (39) were females.58.9% (53)
were smokers, 70% (63) were hypertensive or on antihypertensive
treatment, 53.3% (48) were diabetic and 26.7% (24) were
dyslipidemic.
We demonstrated that BNP threshold of 80 pg/ml
appears able to predict the extension of coronary disease
independently from LV systolic dysfunction and enlargement.
from this study, we found that BNP level significantly
higher in patients with NSTEMI than in patients with unstable
angina (169.64 ± 64.31 pg / ml vs. 63.53 ± 22.61 pg / ml, p.
value < 0.001).
Also we found that LAD affection was significantly
higher in patients with BNP > 80 pg/ml than in patients with
BNP < 80 pg/ml [40 of 49 patients (81.6%) vs. 19 of 41
patients (46.3%), p. value < 0.001].
It was also found that MVD affection was significantly
higher in patients with BNP > 80 pg/ml than in patients with
BNP <80 pg/ml [30 of 49 patients (61.2%) vs. 14 of 41 patients
(34.1%), p. value 0.01].
Our study demonstrated that BNP level was high in
patients with NSTEMI, multivessel disease and left anterior
descending artery affection even in the absence of LV systolic
dysfunction.
from this study we recommended that BNP should be
routinely measured to aid more strong evidence of risk
stratification and also to predict the LAD and multivessel
disease affection.