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N-terminal pro-atrial natriuretic peptide (N-ANP) and N-terminal pro-B-type natriuretic peptide (N-BNP) in the prediction of death and heart failure in unselected patients following acute myocardial infarction.
MedLine Citation:
PMID:  15182235     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elevated plasma natriuretic peptide levels after AMI (acute myocardial infarction) are associated with adverse outcome. The aim of the present study was to examine the relationship of plasma N-ANP (N-terminal pro-atrial natriuretic peptide) and N-BNP (N-terminal pro-B-type natriuretic peptide) with mortality and heart failure following AMI. We studied 403 patients with AMI. Blood was sampled for measurement of N-ANP and N-BNP on a single occasion between 72 and 96 h after symptom onset. Natriuretic peptide levels were related to all-cause mortality and heart failure episodes. During follow up (median, 462 days; range 5-764), 43 (10.7%), 25 (6.2%) and 49 (12.2%) patients suffered death, heart failure hospitalization and outpatient heart failure respectively. Only N-BNP (P < 0.0005), N-ANP (P = 0.005) and previous AMI (P = 0.016) were independently predictive of death. N-BNP, but not N-ANP, predicted 30-day mortality. N-ANP, but not N-BNP, predicted mortality after 30 days. N-BNP was the better predictor of heart failure. N-ANP and N-BNP were above the median in 35 and 38 respectively, of 43 patients who later died. N-ANP, N-BNP, or both were above the median in 41 out of 43 patients. Of 25 patients hospitalized with heart failure, N-ANP and N-BNP was above the median in 20 and 24 respectively, and one or other was elevated in all cases. Above-median N-ANP predicted 36 and N-BNP predicted 41 out of 49 episodes of outpatient heart failure. One or other peptide was above the median in 45 out of 49 patients. Our results indicate that N-BNP predicts 30-day and N-ANP >30-day mortality. We conclude that consideration of both N-ANP and N-BNP identifies a greater number of patients at risk of death or heart failure than either peptide alone.
Authors:
Iain B Squire; Russell J O'Brien; Bettina Demme; Joan E Davies; Leong L Ng
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical science (London, England : 1979)     Volume:  107     ISSN:  0143-5221     ISO Abbreviation:  Clin. Sci.     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-18     Completed Date:  2004-10-12     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7905731     Medline TA:  Clin Sci (Lond)     Country:  England    
Other Details:
Languages:  eng     Pagination:  309-16     Citation Subset:  IM    
Affiliation:
Department of Medicine and Therapeutics, University of Leicester, Leicester Royal Infirmary, LE2 7LX, UK. is11@le.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Atrial Natriuretic Factor / blood*
Biological Markers / blood
Female
Follow-Up Studies
Heart Failure / blood,  etiology
Humans
Male
Middle Aged
Myocardial Infarction / blood*,  complications,  mortality
Natriuretic Peptide, Brain
Nerve Tissue Proteins / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Prognosis
Protein Precursors / blood*
Regression Analysis
Time Factors
Chemical
Reg. No./Substance:
0/Biological Markers; 0/N-terminal proatrial natriuretic peptide; 0/Nerve Tissue Proteins; 0/Peptide Fragments; 0/Protein Precursors; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain; 85637-73-6/Atrial Natriuretic Factor

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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