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Comparison of midregional pro-atrial natriuretic peptide with N-terminal pro-B-type natriuretic peptide in predicting survival in patients with chronic heart failure.
J Am Coll Cardiol. 2007 Nov 13; 50(20):1973-80.JACC

Abstract

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 functional 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 > or =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.

Authors+Show Affiliations

Applied Cachexia Research, Department of Cardiology, Charité Medical School, Berlin, Germany. stephan.von.haehling@web.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 availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Multicenter Study
Validation Study

Language

eng

PubMed ID

17996563

Citation

von Haehling, Stephan, et al. "Comparison of Midregional Pro-atrial Natriuretic Peptide With N-terminal pro-B-type Natriuretic Peptide in Predicting Survival in Patients With Chronic Heart Failure." Journal of the American College of Cardiology, vol. 50, no. 20, 2007, pp. 1973-80.
von Haehling S, Jankowska EA, Morgenthaler NG, et al. Comparison of midregional pro-atrial natriuretic peptide with N-terminal pro-B-type natriuretic peptide in predicting survival in patients with chronic heart failure. J Am Coll Cardiol. 2007;50(20):1973-80.
von Haehling, S., Jankowska, E. A., Morgenthaler, N. G., Vassanelli, C., Zanolla, L., Rozentryt, P., Filippatos, G. S., Doehner, W., Koehler, F., Papassotiriou, J., Kremastinos, D. T., Banasiak, W., Struck, J., Ponikowski, P., Bergmann, A., & Anker, S. D. (2007). Comparison of midregional pro-atrial natriuretic peptide with N-terminal pro-B-type natriuretic peptide in predicting survival in patients with chronic heart failure. Journal of the American College of Cardiology, 50(20), 1973-80.
von Haehling S, et al. Comparison of Midregional Pro-atrial Natriuretic Peptide With N-terminal pro-B-type Natriuretic Peptide in Predicting Survival in Patients With Chronic Heart Failure. J Am Coll Cardiol. 2007 Nov 13;50(20):1973-80. PubMed PMID: 17996563.
* Article titles in AMA citation format should be in sentence-case
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, Y1 - 2007/10/29/ PY - 2006/10/11/received PY - 2007/07/12/revised PY - 2007/08/14/accepted PY - 2007/11/13/pubmed PY - 2007/12/7/medline PY - 2007/11/13/entrez SP - 1973 EP - 80 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 50 IS - 20 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 functional 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 > or =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. SN - 1558-3597 UR - https://www.unboundmedicine.com/medline/citation/17996563/Comparison_of_midregional_pro_atrial_natriuretic_peptide_with_N_terminal_pro_B_type_natriuretic_peptide_in_predicting_survival_in_patients_with_chronic_heart_failure_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735-1097(07)02661-7 DB - PRIME DP - Unbound Medicine ER -