The Investigation of Plasma Natriuretic Peptide as Inflammatory Biomarker Predictor in Coronary Heart Disease Patients With Dry Eye Disease: A Case-Control Study.

Abstract

Background: Inflammation contributes to both coronary heart disease (CHD) and dry eye disease (DED). Recognizing the relationship between CHD and DED is critical for maintaining ocular health in CHD patients. As a result, early monitoring of natriuretic peptides and inflammatory biomarkers may help minimize DED in CHD patients. This study aims to investigate brain-type natriuretic peptide and inflammatory biomarkers in blood in CHD-DED.

Methods: This is a retrospective case-control study among CHD-DED patients at the cardiac outpatient clinic of King Abdulaziz Medical City (Jeddah, Saudi Arabia) from January 2016 to June 2024. The study extracted demographic information and diagnostic values of brain natriuretic peptide (BNP), C-reactive protein (CRP), albumin (Alb), total protein (TP), glycated hemoglobin A1C (HbA1C), troponin I, and creatine kinase (CK) from the electronic medical records of two patient groups: case group; CHD-DED, and control group; CHD only. Statistical analyses were performed via GraphPad Prism. Continuous variables were summarized with appropriate nonparametric descriptive statistics, while categorical variables were reported as frequencies and percentages. Spearman's correlation analyses were conducted to evaluate the associations among BNP, Alb, TP, and CRP within each group. Partial Spearman's correlations were performed using regression residuals to control for potential confounding variables, specifically age and body mass index (BMI).

Results: BMI differed significantly between the CHD and CHD-DED groups (p < 0.001). There were significant differences in BNP levels among the groups (p value = 0.013). In the CHD-DED group, BNP showed a weak, nonsignificant positive correlation with CRP (r = 0.21, p value = 0.08). Conversely, a significant inverse association was noted between BNP and Alb (r = -0.48, p value < 0.001). The inverse relationship between BNP and Alb remained statistically significant, even after adjusting for age and BMI, in contrast to the weakened associations observed between BNP and CRP.

Conclusions: This study forecasts the influence of inflammatory biomarker levels of BNP, CRP, Alb, and TP on the correlation strength in patients with CHD-DED, proposing predictors for identifying DED complications in individuals with CHD. Future research into the role of BNP could elucidate its involvement in other inflammatory conditions.