Document Detail


The prognostic value of N-terminal pro-B-type natriuretic peptide for death and cardiovascular events in healthy normal and stage A/B heart failure subjects.
MedLine Citation:
PMID:  20447539     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Our objective was to determine the prognostic value of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) for death and cardiovascular events among subjects without risk factors for heart failure (HF), which we term healthy normal.
BACKGROUND: Previous studies report that plasma NT-proBNP has prognostic value for cardiovascular events in the general population even in the absence of HF. It is unclear if NT-proBNP retains predictive value in healthy normal subjects.
METHODS: We identified a community-based cohort of 2,042 subjects in Olmsted County, Minnesota. Subjects with symptomatic (stage C/D) HF were excluded. The remaining 1,991 subjects underwent echocardiography and NT-proBNP measurement. We further defined healthy normal (n = 703) and stage A/B HF (n = 1,288) subgroups. Healthy normal was defined as the absence of traditional clinical cardiovascular risk factors and echocardiographic structural cardiac abnormalities. Subjects were followed for death, HF, cerebrovascular accident, and myocardial infarction with median follow-up of 9.1, 8.7, 8.8, and 8.9 years, respectively.
RESULTS: NT-proBNP was not predictive of death or cardiovascular events in the healthy normal subgroup. Similar to previous reports, in stage A/B HF, plasma NT-proBNP values greater than age-/sex-specific 80th percentiles were associated with increased risk of death, HF, cerebrovascular accident, and myocardial infarction (p < 0.001 for all) even after adjustment for clinical risk factors and structural cardiac abnormalities.
CONCLUSIONS: These findings do not support the use of NT-proBNP as a cardiovascular biomarker in healthy normal subjects and have important implications for NT-proBNP-based strategies for early detection and primary prevention of cardiovascular disease.
Authors:
Paul M McKie; Alessandro Cataliotti; Brian D Lahr; Fernando L Martin; Margaret M Redfield; Kent R Bailey; Richard J Rodeheffer; John C Burnett
Related Documents :
2962199 - Atrial natriuretic peptide decreases cardiac output independent of coronary vasoconstri...
17223209 - Utility of plasma apelin and other indices of cardiac dysfunction in the clinical asses...
19782259 - In patients with heart failure and non-ischemic heart disease, cardiac troponin t is a ...
20108079 - Ischemia/reperfusion is an independent trigger for increasing myocardial content of mrn...
7647929 - Incidence and distribution of isolated atrial amyloid: histologic and immunohistochemic...
20053469 - Simultaneous estimation of nt-probnp on top to mitral flow doppler echocardiography as ...
22113759 - Icd implantation in left ventricular noncompaction: a case report and review of the lit...
12535859 - Cardiovascular effects of y-27632, a selective rho-associated kinase inhibitor, assesse...
20362729 - Gender differences in adverse outcomes after contemporary percutaneous coronary interve...
Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  55     ISSN:  1558-3597     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-07     Completed Date:  2010-06-10     Revised Date:  2014-09-11    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2140-7     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Biological Markers / blood
Case-Control Studies
Cohort Studies
Echocardiography, Doppler
Female
Heart Failure / blood*,  diagnosis*,  mortality
Humans
Male
Middle Aged
Natriuretic Peptide, Brain / blood*
Peptide Fragments / blood*
Predictive Value of Tests
Prognosis
Risk Factors
Survival Analysis
Grant Support
ID/Acronym/Agency:
P01 HL076611/HL/NHLBI NIH HHS; R01 AR030582/AR/NIAMS NIH HHS; R01 AR030582-43/AR/NIAMS NIH HHS; R01 HL036634/HL/NHLBI NIH HHS; R01 HL055502/HL/NHLBI NIH HHS; R01 HL36634/HL/NHLBI NIH HHS; R01 HL76611/HL/NHLBI NIH HHS; R01-HL55502/HL/NHLBI NIH HHS; T32 HL007111/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections
Comment In:
J Am Coll Cardiol. 2010 May 11;55(19):2148-9   [PMID:  20447540 ]

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


Previous Document:  Inflammatory markers and incident heart failure risk in older adults: the Health ABC (Health, Aging,...
Next Document:  Elevated heart-type fatty acid-binding protein levels on admission predict an adverse outcome in nor...