Document Detail


Prognostic value of B-type natriuretic peptide for cardiovascular events independent of left ventricular end-diastolic pressure.
MedLine Citation:
PMID:  19853697     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: B-type natriuretic peptide (BNP) correlates with left ventricular (LV) end-diastolic pressure (LVEDP) and predicts cardiovascular events. We sought to determine whether BNP has prognostic value independent of LVEDP. METHODS: Eligible patients were referred for coronary angiography between March 15, 2002, and April 30, 2008, at a single institution. Inclusion criteria were having BNP, LV ejection fraction (EF), and LVEDP measured within 24 hours of the angiogram. The predictive value of BNP for events independent of LVEDP, EF, and other confounders was determined. RESULTS: The study population (n = 1,059) was followed for a mean of 1.8 +/- 1.7 years. The mean age was 63 +/- 13 years. The median BNP value was 182 pg/mL; 59% of patients had LVEDP > or =16 mm Hg. B-type natriuretic peptide and LVEDP had a modest but statistically significant correlation (r = 0.24, P < .0001). After adjustment for LVEDP and EF, the hazard ratio for the composite outcome of heart failure admissions and death was 1.37 (1.21-1.55, P < .0001) per unit increase in log BNP. After adjustment for BNP and EF, LVEDP did not predict heart failure admissions and death (hazard ratio 1.05 [0.95-1.10], per 5-mm Hg increase, P = .30). Those with BNP value below the median had longer event-free survival as compared to those with BNP value above the median, regardless of the LVEDP strata (log-rank P < .0001 for LVEDP > or =16 and <16 mm Hg). CONCLUSION: B-type natriuretic peptide has prognostic value independent of LVEDP in this cohort with suspected coronary artery disease, suggesting this biomarker is not just a prognostic surrogate for elevated LV filling pressure.
Authors:
Robert Kevin Rogers; Heidi T May; Jeffrey L Anderson; J Brent Muhlestein
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  158     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-26     Completed Date:  2009-12-31     Revised Date:  2010-03-16    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  777-83     Citation Subset:  AIM; IM    
Affiliation:
University of Utah, Salt Lake City, 84132-2401, USA. kevin.rogers@hsc.utah.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Coronary Artery Disease / blood*,  diagnosis*
Diastole
Female
Heart Ventricles / physiopathology*
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Predictive Value of Tests
Prognosis
Chemical
Reg. No./Substance:
0/Biological Markers; 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
Am Heart J. 2010 Mar;159(3):e15; author reply e17   [PMID:  20211288 ]

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


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