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B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction.
Circulation. 2003 Jun 10; 107(22):2786-92.Circ

Abstract

BACKGROUND

A recent landmark report has demonstrated that plasma B-type natriuretic peptide (BNP) measured in acute coronary syndromes independently predicts mortality, heart failure, and new myocardial infarction. After acute cardiac injury, left ventricular ejection fraction (LVEF) is also of prognostic significance and plays a major role in determining the therapeutic response.

METHODS AND RESULTS

The present report is the first from a substantial (n=666) cohort of patients with acute myocardial infarction to test the prognostic utility of concurrent measurements of BNP, amino-terminal BNP (N-BNP), norepinephrine, and radionuclide LVEF. The B-type peptides and LVEF were predictors of death, heart failure, and new myocardial infarction (all P<0.001) independent of patient age, gender, previous myocardial infarction, antecedent hypertension or diabetes, previous heart failure, plasma norepinephrine, creatinine, cholesterol, drug therapy, and coronary revascularization procedures. The combination of N-BNP (or BNP) with LVEF substantially improved risk stratification beyond that provided by either alone. Elevated N-BNP (or BNP) predicted new myocardial infarction only in patients with LVEF <40%. LVEF <40% coupled to N-BNP over the group median conferred substantial 3-year risks of death, heart failure, and new myocardial infarction of 37%, 18%, and 26%, respectively. N-BNP and BNP were equivalent prognostic markers for these clinical outcomes.

CONCLUSIONS

Plasma N-BNP (or BNP) and LVEF are complementary independent predictors of major adverse events on follow-up after myocardial infarction. Combined measurement provides risk stratification substantially better than that provided by either alone.

Authors+Show Affiliations

Christchurch Cardioendocrine Research Group, Christchurch School of Medicine and Health Sciences, PO Box 4345, Christchurch, New Zealand. mark.richards@cdhb.govt.nzNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Controlled Clinical Trial
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

12771003

Citation

Richards, A Mark, et al. "B-type Natriuretic Peptides and Ejection Fraction for Prognosis After Myocardial Infarction." Circulation, vol. 107, no. 22, 2003, pp. 2786-92.
Richards AM, Nicholls MG, Espiner EA, et al. B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction. Circulation. 2003;107(22):2786-92.
Richards, A. M., Nicholls, M. G., Espiner, E. A., Lainchbury, J. G., Troughton, R. W., Elliott, J., Frampton, C., Turner, J., Crozier, I. G., & Yandle, T. G. (2003). B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction. Circulation, 107(22), 2786-92.
Richards AM, et al. B-type Natriuretic Peptides and Ejection Fraction for Prognosis After Myocardial Infarction. Circulation. 2003 Jun 10;107(22):2786-92. PubMed PMID: 12771003.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B-type natriuretic peptides and ejection fraction for prognosis after myocardial infarction. AU - Richards,A Mark, AU - Nicholls,M Gary, AU - Espiner,Eric A, AU - Lainchbury,John G, AU - Troughton,Richard W, AU - Elliott,John, AU - Frampton,Christopher, AU - Turner,John, AU - Crozier,Ian G, AU - Yandle,Timothy G, Y1 - 2003/05/27/ PY - 2003/5/29/pubmed PY - 2003/6/26/medline PY - 2003/5/29/entrez SP - 2786 EP - 92 JF - Circulation JO - Circulation VL - 107 IS - 22 N2 - BACKGROUND: A recent landmark report has demonstrated that plasma B-type natriuretic peptide (BNP) measured in acute coronary syndromes independently predicts mortality, heart failure, and new myocardial infarction. After acute cardiac injury, left ventricular ejection fraction (LVEF) is also of prognostic significance and plays a major role in determining the therapeutic response. METHODS AND RESULTS: The present report is the first from a substantial (n=666) cohort of patients with acute myocardial infarction to test the prognostic utility of concurrent measurements of BNP, amino-terminal BNP (N-BNP), norepinephrine, and radionuclide LVEF. The B-type peptides and LVEF were predictors of death, heart failure, and new myocardial infarction (all P<0.001) independent of patient age, gender, previous myocardial infarction, antecedent hypertension or diabetes, previous heart failure, plasma norepinephrine, creatinine, cholesterol, drug therapy, and coronary revascularization procedures. The combination of N-BNP (or BNP) with LVEF substantially improved risk stratification beyond that provided by either alone. Elevated N-BNP (or BNP) predicted new myocardial infarction only in patients with LVEF <40%. LVEF <40% coupled to N-BNP over the group median conferred substantial 3-year risks of death, heart failure, and new myocardial infarction of 37%, 18%, and 26%, respectively. N-BNP and BNP were equivalent prognostic markers for these clinical outcomes. CONCLUSIONS: Plasma N-BNP (or BNP) and LVEF are complementary independent predictors of major adverse events on follow-up after myocardial infarction. Combined measurement provides risk stratification substantially better than that provided by either alone. SN - 1524-4539 UR - https://www.unboundmedicine.com/medline/citation/12771003/B_type_natriuretic_peptides_and_ejection_fraction_for_prognosis_after_myocardial_infarction_ L2 - https://www.ahajournals.org/doi/10.1161/01.CIR.0000070953.76250.B9?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -