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B-type natriuretic peptide and the risk of cardiovascular events and death in patients with stable angina: results from the AtheroGene study.
J Am Coll Cardiol. 2006 Feb 07; 47(3):552-8.JACC

Abstract

OBJECTIVES

The aim of this study was to assess the predictive value of the cardiac hormone B-type natriuretic peptide (BNP) for long-term outcome in a large cohort of stable angina patients.

BACKGROUND

Recent data suggest a role of BNP in stable ischemic heart disease beyond its known value in heart failure and acute coronary syndromes.

METHODS

In 1,085 patients with coronary artery disease (CAD) baseline levels of BNP were prospectively associated with cardiovascular (CV) events during a mean follow-up of 2.5 years.

RESULTS

BNP concentrations were significantly elevated in patients with future CV events (median [25th/75th interquartile range] 119.2 [43.6/300.4] pg/ml vs. 36.2 [11.3/94.6] pg/ml; p < 0.001). Kaplan-Meier survival analysis showed a stepwise decrease in event-free survival across quartiles of BNP baseline concentration (p(log rank) < 0.001). Patients in the highest quartile revealed a 6.1-fold increased risk (p = 0.001) compared to patients in the lowest quartile after adjustment for potential confounders. For a cut-off value of 100 pg/ml, an independently increased risk of adverse outcome (hazard ratio [HR] 4.4; p < 0.001) could be demonstrated. One standard deviation (SD) decrease in ejection fraction implied the most prominent increase in risk of future CV events (HR 1.69; p < 0.001) followed by one SD increase in BNP (HR 1.53; p < 0.001). The highest prognostic accuracy could be demonstrated for BNP (area under the curve 0.671).

CONCLUSIONS

The data of this large group of CAD patients provide independent evidence that BNP is a strong predictor of cardiovascular risk in patients with stable angina independent of left ventricular systolic performance and known risk factors.

Authors+Show Affiliations

Department of Medicine II, Johannes Gutenberg University, Mainz, Germany. schnabelr@gmx.deNo 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)

Journal Article

Language

eng

PubMed ID

16458135

Citation

Schnabel, Renate, et al. "B-type Natriuretic Peptide and the Risk of Cardiovascular Events and Death in Patients With Stable Angina: Results From the AtheroGene Study." Journal of the American College of Cardiology, vol. 47, no. 3, 2006, pp. 552-8.
Schnabel R, Lubos E, Rupprecht HJ, et al. B-type natriuretic peptide and the risk of cardiovascular events and death in patients with stable angina: results from the AtheroGene study. J Am Coll Cardiol. 2006;47(3):552-8.
Schnabel, R., Lubos, E., Rupprecht, H. J., Espinola-Klein, C., Bickel, C., Lackner, K. J., Cambien, F., Tiret, L., Münzel, T., & Blankenberg, S. (2006). B-type natriuretic peptide and the risk of cardiovascular events and death in patients with stable angina: results from the AtheroGene study. Journal of the American College of Cardiology, 47(3), 552-8.
Schnabel R, et al. B-type Natriuretic Peptide and the Risk of Cardiovascular Events and Death in Patients With Stable Angina: Results From the AtheroGene Study. J Am Coll Cardiol. 2006 Feb 7;47(3):552-8. PubMed PMID: 16458135.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - B-type natriuretic peptide and the risk of cardiovascular events and death in patients with stable angina: results from the AtheroGene study. AU - Schnabel,Renate, AU - Lubos,Edith, AU - Rupprecht,Hans J, AU - Espinola-Klein,Christine, AU - Bickel,Christoph, AU - Lackner,Karl J, AU - Cambien,François, AU - Tiret,Laurence, AU - Münzel,Thomas, AU - Blankenberg,Stefan, Y1 - 2006/01/18/ PY - 2005/06/22/received PY - 2005/09/13/revised PY - 2005/09/19/accepted PY - 2006/2/7/pubmed PY - 2006/3/28/medline PY - 2006/2/7/entrez SP - 552 EP - 8 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 47 IS - 3 N2 - OBJECTIVES: The aim of this study was to assess the predictive value of the cardiac hormone B-type natriuretic peptide (BNP) for long-term outcome in a large cohort of stable angina patients. BACKGROUND: Recent data suggest a role of BNP in stable ischemic heart disease beyond its known value in heart failure and acute coronary syndromes. METHODS: In 1,085 patients with coronary artery disease (CAD) baseline levels of BNP were prospectively associated with cardiovascular (CV) events during a mean follow-up of 2.5 years. RESULTS: BNP concentrations were significantly elevated in patients with future CV events (median [25th/75th interquartile range] 119.2 [43.6/300.4] pg/ml vs. 36.2 [11.3/94.6] pg/ml; p < 0.001). Kaplan-Meier survival analysis showed a stepwise decrease in event-free survival across quartiles of BNP baseline concentration (p(log rank) < 0.001). Patients in the highest quartile revealed a 6.1-fold increased risk (p = 0.001) compared to patients in the lowest quartile after adjustment for potential confounders. For a cut-off value of 100 pg/ml, an independently increased risk of adverse outcome (hazard ratio [HR] 4.4; p < 0.001) could be demonstrated. One standard deviation (SD) decrease in ejection fraction implied the most prominent increase in risk of future CV events (HR 1.69; p < 0.001) followed by one SD increase in BNP (HR 1.53; p < 0.001). The highest prognostic accuracy could be demonstrated for BNP (area under the curve 0.671). CONCLUSIONS: The data of this large group of CAD patients provide independent evidence that BNP is a strong predictor of cardiovascular risk in patients with stable angina independent of left ventricular systolic performance and known risk factors. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/16458135/B_type_natriuretic_peptide_and_the_risk_of_cardiovascular_events_and_death_in_patients_with_stable_angina:_results_from_the_AtheroGene_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(05)02643-4 DB - PRIME DP - Unbound Medicine ER -