TY - JOUR
T1 - Comparison of Midregional Pro-Atrial Natriuretic Peptide With N-Terminal Pro-B-Type Natriuretic Peptide in Predicting Survival in Patients With Chronic Heart Failure
AU - von Haehling, Stephan
AU - Jankowska, Ewa A.
AU - Morgenthaler, Nils G.
AU - Vassanelli, Corrado
AU - Zanolla, Luisa
AU - Rozentryt, Piotr
AU - Filippatos, Gerasimos S.
AU - Doehner, Wolfram
AU - Koehler, Friedrich
AU - Papassotiriou, Jana
AU - Kremastinos, Dimitrios T.
AU - Banasiak, Waldemar
AU - Struck, Joachim
AU - Ponikowski, Piotr
AU - Bergmann, Andreas
AU - Anker, Stefan D.
PY - 2007/11/13
Y1 - 2007/11/13
N2 - Objectives: Our aim was assess the prognostic value of midregional pro-atrial natriuretic peptide (MR-proANP) using a new immunoassay in patients with chronic heart failure (HF). Background: Assessment of natriuretic peptides represents a useful addition in establishing the diagnosis of chronic HF. Their plasma values are powerful predictors of survival in chronic HF. Methods: We assessed MR-proANP in 525 chronic HF patients (derivation study: age 61 ± 12 years, New York Heart Association (NYHA) functional class I/II/III/IV 6%/44%/41%/9%, N-terminal pro-B-type natriuretic peptide (NT-proBNP) 3,637 ± 6,362 pg/ml) and validated our findings in 249 additional chronic HF patients (age 63 ± 9 years, NYHA functional class I/II/III/IV 14%/50%/33%/3%, NT-proBNP 1,116 ± 1,991 pg/ml). Results: The MR-proANP levels (mean 339 ± 306 pmol/l, range 24.5 to 2,280 pmol/l) increased with NYHA funcitonal class (p <0.0001). During follow-up (>6 months in survivors), 171 patients (33%) died. Increasing MR-proANP was a predictor of poor survival (risk ratio 1.35 per increase in standard deviation, 95% confidence interval 1.17 to 1.57; p = 0.0061), adjusted for NT-proBNP, age, left ventricular ejection fraction, NYHA functional class, creatinine, and body mass index (BMI). In receiver operating characteristic curve analysis of 12-month survival, the area under the curve for MR-proANP was 0.74 and that of NT-proBNP was 0.75 (p = 0.7). In a validation study, MR-proANP levels above the optimal prognostic cutoff value from the validation cohort remained a significant independent predictor of death. In chronic HF patients in NYHA functional class II to III and all subgroups of BMI and kidney function, MR-proANP added prognostic value to NT-proBNP. In patients with BMI ≥30 kg/m2, MR-proANP had higher prognostic power than NT-proBNP. Conclusions: Midregional proANP is an independent predictor of mortality in patients with chronic HF. Midregional proANP adds prognostic information to NT-proBNP.
AB - Objectives: Our aim was assess the prognostic value of midregional pro-atrial natriuretic peptide (MR-proANP) using a new immunoassay in patients with chronic heart failure (HF). Background: Assessment of natriuretic peptides represents a useful addition in establishing the diagnosis of chronic HF. Their plasma values are powerful predictors of survival in chronic HF. Methods: We assessed MR-proANP in 525 chronic HF patients (derivation study: age 61 ± 12 years, New York Heart Association (NYHA) functional class I/II/III/IV 6%/44%/41%/9%, N-terminal pro-B-type natriuretic peptide (NT-proBNP) 3,637 ± 6,362 pg/ml) and validated our findings in 249 additional chronic HF patients (age 63 ± 9 years, NYHA functional class I/II/III/IV 14%/50%/33%/3%, NT-proBNP 1,116 ± 1,991 pg/ml). Results: The MR-proANP levels (mean 339 ± 306 pmol/l, range 24.5 to 2,280 pmol/l) increased with NYHA funcitonal class (p <0.0001). During follow-up (>6 months in survivors), 171 patients (33%) died. Increasing MR-proANP was a predictor of poor survival (risk ratio 1.35 per increase in standard deviation, 95% confidence interval 1.17 to 1.57; p = 0.0061), adjusted for NT-proBNP, age, left ventricular ejection fraction, NYHA functional class, creatinine, and body mass index (BMI). In receiver operating characteristic curve analysis of 12-month survival, the area under the curve for MR-proANP was 0.74 and that of NT-proBNP was 0.75 (p = 0.7). In a validation study, MR-proANP levels above the optimal prognostic cutoff value from the validation cohort remained a significant independent predictor of death. In chronic HF patients in NYHA functional class II to III and all subgroups of BMI and kidney function, MR-proANP added prognostic value to NT-proBNP. In patients with BMI ≥30 kg/m2, MR-proANP had higher prognostic power than NT-proBNP. Conclusions: Midregional proANP is an independent predictor of mortality in patients with chronic HF. Midregional proANP adds prognostic information to NT-proBNP.
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U2 - 10.1016/j.jacc.2007.08.012
DO - 10.1016/j.jacc.2007.08.012
M3 - Article
C2 - 17996563
AN - SCOPUS:35748935092
VL - 50
SP - 1973
EP - 1980
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 20
ER -