Pro-C-Type Natriuretic Peptide in Women With Angina Pectoris and No Obstructive Coronary Artery Disease

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BACKGROUND: Circulating C-type natriuretic peptides (CNPs) predict adverse outcome in women presenting with ST-elevation myocardial infarction. OBJECTIVES: The purpose of this study was to determine the prognostic impact of a high proCNP concentration in women with angina pectoris but no obstructive coronary artery disease (ANOCA). METHODS: In a prospective cohort of women with ANOCA, we assessed the baseline associations between proCNP concentrations in plasma and clinical data. Moreover, we performed exploratory partial least squares regression (PLS) analyses for correlation patterns of proCNP with 185 cardiovascular plasma markers. We included 1,508 women in baseline/follow-up analyses and 1,598 women in PLS analyses. Follow-up analyses included all-cause death and a composite endpoint of cardiovascular events, where we calculated HR estimates from crude and adjusted (age, creatinine) Cox proportional hazards models. RESULTS: : 1.03 [95% CI: 0.68-1.56]; P = 0.90). CONCLUSIONS: In women with ANOCA, a high circulating proCNP concentration is associated with a distinct cardiovascular risk profile beyond pro-inflammatory biomarkers and an increased risk of all-cause mortality.

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