Document Detail

Baseline plasma NT-proBNP and clinical characteristics: results from the irbesartan in heart failure with preserved ejection fraction trial.
MedLine Citation:
PMID:  20142024     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: N-terminal B type natriuretic peptide (NT-proBNP) is usually elevated in heart failure (HF) patients with reduced ejection fraction (EF). Less is known about NT-proBNP in HF with preserved EF (HF-PEF). We measured baseline NT-proBNP in 3562 HF-PEF enrolled patients in the Irbesartan in Heart Failure with Preserved Ejection Fraction trial. METHODS AND RESULTS: Patients with EF >or=45%, age >or=60 years, and either New York Heart Association (NYHA) II-IV symptoms with HF hospitalization (HFH) within 6 months or NYHA III-IV symptoms with corroborative evidence of HF or structural changes associated with HF-PEF. NT-proBNP (pg/mL) measured centrally using the Elecsys proBNP assay (Roche). Mean age 72 +/- 7 years, 60% were women, the investigator indicated HF etiology was hypertension in 64%; the majority were in NYHA III. Medications included diuretics in 82%, angiotensin-converting enzyme inhibitor in 26%, beta-blocker in 59%, and spironolactone in 15%. Median NT-proBNP was 341 pg/mL (interquartile range 135 to 974 pg/mL) and geometric mean was 354 pg/mL. In multivariate analysis, the baseline characteristics most strongly associated with higher NT-proBNP levels were atrial fibrillation (ratio of geometric mean 2.59, P < .001), NYHA IV symptoms (1.52, P < .001), lower estimated glomerular filtration rate (1.44, P < .001), and HFH hospitalization within 6 months (1.37, P < .001). CONCLUSIONS: Most HF-PEF patients have elevated NT-proBNP levels. The NT-proBNP concentrations were related to baseline characteristics generally associated with worse outcomes for HF patients.
Robert S McKelvie; Michel Komajda; John McMurray; Michael Zile; Agata Ptaszynska; Mark Donovan; Peter Carson; Barry M Massie;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial     Date:  2009-11-04
Journal Detail:
Title:  Journal of cardiac failure     Volume:  16     ISSN:  1532-8414     ISO Abbreviation:  J. Card. Fail.     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-09     Completed Date:  2010-09-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9442138     Medline TA:  J Card Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  128-34     Citation Subset:  IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada.
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MeSH Terms
Biological Markers / blood
Biphenyl Compounds / therapeutic use*
Double-Blind Method
Heart Failure / blood*,  drug therapy*,  physiopathology
Middle Aged
Natriuretic Peptide, Brain / biosynthesis,  blood*
Peptide Fragments / biosynthesis,  blood*
Protein Precursors / biosynthesis,  blood*
Stroke Volume / drug effects,  physiology*
Tetrazoles / therapeutic use*
Reg. No./Substance:
0/Biological Markers; 0/Biphenyl Compounds; 0/Peptide Fragments; 0/Protein Precursors; 0/Tetrazoles; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 138402-11-6/irbesartan

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