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N-terminal pro-atrial natriuretic peptide (N-ANP) and N-terminal pro-B-type natriuretic peptide (N-BNP) in the prediction of death and heart failure in unselected patients following acute myocardial infarction.
Clin Sci (Lond). 2004 Sep; 107(3):309-16.CS

Abstract

Elevated plasma natriuretic peptide levels after AMI (acute myocardial infarction) are associated with adverse outcome. The aim of the present study was to examine the relationship of plasma N-ANP (N-terminal pro-atrial natriuretic peptide) and N-BNP (N-terminal pro-B-type natriuretic peptide) with mortality and heart failure following AMI. We studied 403 patients with AMI. Blood was sampled for measurement of N-ANP and N-BNP on a single occasion between 72 and 96 h after symptom onset. Natriuretic peptide levels were related to all-cause mortality and heart failure episodes. During follow up (median, 462 days; range 5-764), 43 (10.7%), 25 (6.2%) and 49 (12.2%) patients suffered death, heart failure hospitalization and outpatient heart failure respectively. Only N-BNP (P < 0.0005), N-ANP (P = 0.005) and previous AMI (P = 0.016) were independently predictive of death. N-BNP, but not N-ANP, predicted 30-day mortality. N-ANP, but not N-BNP, predicted mortality after 30 days. N-BNP was the better predictor of heart failure. N-ANP and N-BNP were above the median in 35 and 38 respectively, of 43 patients who later died. N-ANP, N-BNP, or both were above the median in 41 out of 43 patients. Of 25 patients hospitalized with heart failure, N-ANP and N-BNP was above the median in 20 and 24 respectively, and one or other was elevated in all cases. Above-median N-ANP predicted 36 and N-BNP predicted 41 out of 49 episodes of outpatient heart failure. One or other peptide was above the median in 45 out of 49 patients. Our results indicate that N-BNP predicts 30-day and N-ANP >30-day mortality. We conclude that consideration of both N-ANP and N-BNP identifies a greater number of patients at risk of death or heart failure than either peptide alone.

Authors+Show Affiliations

Department of Medicine and Therapeutics, University of Leicester, Leicester Royal Infirmary, LE2 7LX, UK. is11@le.ac.ukNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15182235

Citation

Squire, Iain B., et al. "N-terminal Pro-atrial Natriuretic Peptide (N-ANP) and N-terminal pro-B-type Natriuretic Peptide (N-BNP) in the Prediction of Death and Heart Failure in Unselected Patients Following Acute Myocardial Infarction." Clinical Science (London, England : 1979), vol. 107, no. 3, 2004, pp. 309-16.
Squire IB, O'Brien RJ, Demme B, et al. N-terminal pro-atrial natriuretic peptide (N-ANP) and N-terminal pro-B-type natriuretic peptide (N-BNP) in the prediction of death and heart failure in unselected patients following acute myocardial infarction. Clin Sci (Lond). 2004;107(3):309-16.
Squire, I. B., O'Brien, R. J., Demme, B., Davies, J. E., & Ng, L. L. (2004). N-terminal pro-atrial natriuretic peptide (N-ANP) and N-terminal pro-B-type natriuretic peptide (N-BNP) in the prediction of death and heart failure in unselected patients following acute myocardial infarction. Clinical Science (London, England : 1979), 107(3), 309-16.
Squire IB, et al. N-terminal Pro-atrial Natriuretic Peptide (N-ANP) and N-terminal pro-B-type Natriuretic Peptide (N-BNP) in the Prediction of Death and Heart Failure in Unselected Patients Following Acute Myocardial Infarction. Clin Sci (Lond). 2004;107(3):309-16. PubMed PMID: 15182235.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - N-terminal pro-atrial natriuretic peptide (N-ANP) and N-terminal pro-B-type natriuretic peptide (N-BNP) in the prediction of death and heart failure in unselected patients following acute myocardial infarction. AU - Squire,Iain B, AU - O'Brien,Russell J, AU - Demme,Bettina, AU - Davies,Joan E, AU - Ng,Leong L, PY - 2004/06/07/accepted PY - 2004/04/28/revised PY - 2004/03/17/received PY - 2004/6/9/pubmed PY - 2004/10/13/medline PY - 2004/6/9/entrez SP - 309 EP - 16 JF - Clinical science (London, England : 1979) JO - Clin Sci (Lond) VL - 107 IS - 3 N2 - Elevated plasma natriuretic peptide levels after AMI (acute myocardial infarction) are associated with adverse outcome. The aim of the present study was to examine the relationship of plasma N-ANP (N-terminal pro-atrial natriuretic peptide) and N-BNP (N-terminal pro-B-type natriuretic peptide) with mortality and heart failure following AMI. We studied 403 patients with AMI. Blood was sampled for measurement of N-ANP and N-BNP on a single occasion between 72 and 96 h after symptom onset. Natriuretic peptide levels were related to all-cause mortality and heart failure episodes. During follow up (median, 462 days; range 5-764), 43 (10.7%), 25 (6.2%) and 49 (12.2%) patients suffered death, heart failure hospitalization and outpatient heart failure respectively. Only N-BNP (P < 0.0005), N-ANP (P = 0.005) and previous AMI (P = 0.016) were independently predictive of death. N-BNP, but not N-ANP, predicted 30-day mortality. N-ANP, but not N-BNP, predicted mortality after 30 days. N-BNP was the better predictor of heart failure. N-ANP and N-BNP were above the median in 35 and 38 respectively, of 43 patients who later died. N-ANP, N-BNP, or both were above the median in 41 out of 43 patients. Of 25 patients hospitalized with heart failure, N-ANP and N-BNP was above the median in 20 and 24 respectively, and one or other was elevated in all cases. Above-median N-ANP predicted 36 and N-BNP predicted 41 out of 49 episodes of outpatient heart failure. One or other peptide was above the median in 45 out of 49 patients. Our results indicate that N-BNP predicts 30-day and N-ANP >30-day mortality. We conclude that consideration of both N-ANP and N-BNP identifies a greater number of patients at risk of death or heart failure than either peptide alone. SN - 0143-5221 UR - https://www.unboundmedicine.com/medline/citation/15182235/N_terminal_pro_atrial_natriuretic_peptide__N_ANP__and_N_terminal_pro_B_type_natriuretic_peptide__N_BNP__in_the_prediction_of_death_and_heart_failure_in_unselected_patients_following_acute_myocardial_infarction_ L2 - https://portlandpress.com/clinsci/article-lookup/doi/10.1042/CS20040087 DB - PRIME DP - Unbound Medicine ER -