| 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. | |
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MedLine Citation:
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PMID: 15182235 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Iain B Squire; Russell J O'Brien; Bettina Demme; Joan E Davies; Leong L Ng |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Clinical science (London, England : 1979) Volume: 107 ISSN: 0143-5221 ISO Abbreviation: Clin. Sci. Publication Date: 2004 Sep |
Date Detail:
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Created Date: 2004-08-18 Completed Date: 2004-10-12 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 7905731 Medline TA: Clin Sci (Lond) Country: England |
Other Details:
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Languages: eng Pagination: 309-16 Citation Subset: IM |
Affiliation:
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Department of Medicine and Therapeutics, University of Leicester, Leicester Royal Infirmary, LE2 7LX, UK. is11@le.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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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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