en Cardiology Cardiology Original Research Original Research <strong>Background: </strong>N-terminal pro-brain natriuretic peptide (NT-ProBNP) increases during myocardial ischemia and has a potential for the diagnosis of patients with coronary artery disease (CAD). We aimed to determine the incremental diagnostic value of NT-ProBNP in the selection of patients with positive myocardial perfusion imaging (MPI) for coronary angiography. We also tested the association between the level of NT-ProBNP and severity of CAD based on the vessel score and Gensini score.<br> &nbsp;&nbsp; <strong>Methods: </strong>In this cross-sectional study, stable angina patients with positive MPI who were assessed by coronary angiography in Imam Khomeini Hospitalwere enrolled. After the collection of demographic and clinical data, NT-ProBNP was measured in all patients on the day of coronary angiography, and its association with the presence of CAD, vessel score and Gensini score was tested.<br> &nbsp;&nbsp; <strong>Results:</strong> We enrolled 170 patients (mean age61.2&plusmn;10.1 years, 86 males (50.6%)).&nbsp; Seventy-two (42.3%) patients had at least one stenotic vessel. NT-Pro BNP was significantly higher in the CAD-positive group (OR=1.01, 95% CI: 1.00-1.02; p=0.008) and could independently predict the presence of CAD at a cut-off point of 69.5, with a sensitivity of 55.6%, specificity of 82.5% and diagnostic accuracy of 61.7%. The Gensini score had a modest correlation with NT-Pro BNP (r=0.60, p<0.001). The combination of MPI result and NT-Pro BNP could predict the presence of CAD (OR=14.57, 95% CI: 4.28, 49.56; p<0.001).<br> &nbsp;&nbsp; <strong>Conclusion:</strong> Serum level of NT-Pro BNP alone and its combination with the results of MPI can significantly predict the presence of CAD and therefore, highlights the need for performing coronary angiography. Coronary artery disease, NT-Pro brain natriuretic peptide, Myocardial perfusion imaging, Coronary angiography, Diagnosis 75 79 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-4075-1&slc_lang=en&sid=1 Reza Rahmani r_rahmani@tums.ac.ir 200319475328460062862 200319475328460062862 Yes Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Akbar Shafiee dr_shafiee@alborzi.com 200319475328460062863 200319475328460062863 No Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran Kambiz Parazaran Kambizparazaran@yahoo.com 200319475328460062864 200319475328460062864 No Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran Najmeh Reshadati naharasha@yahoo.com 200319475328460062865 200319475328460062865 No Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran