| Prognostic value of renin and prorenin in heart failure patients with decreased kidney function. | |
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MedLine Citation:
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PMID: 21884865 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND: The renin-angiotensin-aldosterone system (RAAS) plays a key role in the progression of heart failure (HF) and concomitant kidney dysfunction. Despite the use of RAAS blockade, sustained activation of RAAS has been suggested to link with adverse outcome. We aimed to investigate the prognostic value of active plasma renin concentration (APRC) and prorenin in patients with HF treated with RAAS-blocking agents and its relationship with kidney function parameters. METHODS: One hundred clinically stable patients with HF, treated with RAAS-blocking agents, were studied. Renal function parameters including effective renal plasma flow and glomerular filtration rate were measured invasively. The combined end point consisted of all-cause mortality, heart transplantation, and admission to hospital for HF. RESULTS: Mean age was 58 ± 12 years, and 76% were men. Mean left ventricular ejection fraction was 28 ± 9, and median APRC levels were 24.3 ng/mL per hour. Active plasma renin concentration was most strongly associated with mean arterial pressure (r = 0.60, P < .001). In multivariate linear regression analysis, age, mean arterial pressure, angiotensin II concentration, and use of aldosterone antagonists were significantly related with APRC (adjusted R(2) = 0.53). Patients in the highest quartile of APRC had a worse prognosis. In multivariate analysis, APRC remained associated with worse prognosis: HR 2.87 (95% CI 1.14-7.20), P = .025. Prorenin did not show prognostic value. The prognostic value of APRC was strongest in patients with decreased kidney function. CONCLUSIONS: Our data indicate that APRC is a strong prognostic factor in patients with HF in the presence of RAAS inhibition, especially in patients with kidney dysfunction. |
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Authors:
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Mariusz K Szymanski; Kevin Damman; Dirk J van Veldhuisen; Wiek H van Gilst; Hans L Hillege; Rudolf A de Boer |
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Publication Detail:
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Type: Journal Article Date: 2011-07-26 |
Journal Detail:
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Title: American heart journal Volume: 162 ISSN: 1097-6744 ISO Abbreviation: Am. Heart J. Publication Date: 2011 Sep |
Date Detail:
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Created Date: 2011-09-02 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: United States |
Other Details:
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Languages: eng Pagination: 487-93 Citation Subset: AIM; IM |
Copyright Information:
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Copyright © 2011 Mosby, Inc. All rights reserved. |
Affiliation:
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Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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