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Usefulness of serial N-terminal pro-B-type natriuretic peptide measurements for determining prognosis in patients with pulmonary arterial hypertension.
Am J Cardiol. 2011 Dec 01; 108(11):1645-50.AJ

Abstract

Previous studies have shown the prognostic benefit of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) in pulmonary arterial hypertension (PAH) at time of diagnosis. However, there are only limited data on the clinical utility of serial measurements of the inactive peptide NT-pro-BNP in PAH. This study examined the value of serial NT-pro-BNP measurements in predicting prognosis PAH. We retrospectively analyzed all available NT-pro-BNP plasma samples in 198 patients who were diagnosed with World Health Organization group I PAH from January 2002 through January 2009. At time of diagnosis median NT-pro-BNP levels were significantly different between survivors (610 pg/ml, range 6 to 8,714) and nonsurvivors (2,609 pg/ml, range 28 to 9,828, p <0.001). In addition, NT-pro-BNP was significantly associated (p <0.001) with other parameters of disease severity (6-minute walking distance, functional class). Receiver operating curve analysis identified ≥1,256 pg/ml as the optimal NT-pro-BNP cutoff for predicting mortality at time of diagnosis. Serial measurements allowed calculation of baseline NT-pro-BNP (i.e., intercept obtained by back-extrapolation of concentration-time graph), providing a better discrimination between survivors and nonsurvivors than NT-pro-BNP at time of diagnosis alone (p = 0.010). Furthermore, a decrease of NT-pro-BNP of >15%/year was associated with survival. In conclusion, a serum NT-pro-BNP level ≥1,256 pg/ml at time of diagnosis identifies poor outcome in patients with PAH. In addition, a decrease in NT-pro-BNP of >15%/year is associated with survival in PAH.

Authors+Show Affiliations

Department of Pulmonary Diseases, Institute for Cardiovascular Research, VU University Medical Center, Amsterdam, The Netherlands.No 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
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21890089

Citation

Mauritz, Gert-Jan, et al. "Usefulness of Serial N-terminal pro-B-type Natriuretic Peptide Measurements for Determining Prognosis in Patients With Pulmonary Arterial Hypertension." The American Journal of Cardiology, vol. 108, no. 11, 2011, pp. 1645-50.
Mauritz GJ, Rizopoulos D, Groepenhoff H, et al. Usefulness of serial N-terminal pro-B-type natriuretic peptide measurements for determining prognosis in patients with pulmonary arterial hypertension. Am J Cardiol. 2011;108(11):1645-50.
Mauritz, G. J., Rizopoulos, D., Groepenhoff, H., Tiede, H., Felix, J., Eilers, P., Bosboom, J., Postmus, P. E., Westerhof, N., & Vonk-Noordegraaf, A. (2011). Usefulness of serial N-terminal pro-B-type natriuretic peptide measurements for determining prognosis in patients with pulmonary arterial hypertension. The American Journal of Cardiology, 108(11), 1645-50. https://doi.org/10.1016/j.amjcard.2011.07.025
Mauritz GJ, et al. Usefulness of Serial N-terminal pro-B-type Natriuretic Peptide Measurements for Determining Prognosis in Patients With Pulmonary Arterial Hypertension. Am J Cardiol. 2011 Dec 1;108(11):1645-50. PubMed PMID: 21890089.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Usefulness of serial N-terminal pro-B-type natriuretic peptide measurements for determining prognosis in patients with pulmonary arterial hypertension. AU - Mauritz,Gert-Jan, AU - Rizopoulos,Dimitris, AU - Groepenhoff,Herman, AU - Tiede,Henning, AU - Felix,Janine, AU - Eilers,Paul, AU - Bosboom,Joachim, AU - Postmus,Pieter E, AU - Westerhof,Nico, AU - Vonk-Noordegraaf,Anton, Y1 - 2011/09/03/ PY - 2011/04/19/received PY - 2011/07/07/revised PY - 2011/07/07/accepted PY - 2011/9/6/entrez PY - 2011/9/6/pubmed PY - 2012/1/4/medline SP - 1645 EP - 50 JF - The American journal of cardiology JO - Am J Cardiol VL - 108 IS - 11 N2 - Previous studies have shown the prognostic benefit of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) in pulmonary arterial hypertension (PAH) at time of diagnosis. However, there are only limited data on the clinical utility of serial measurements of the inactive peptide NT-pro-BNP in PAH. This study examined the value of serial NT-pro-BNP measurements in predicting prognosis PAH. We retrospectively analyzed all available NT-pro-BNP plasma samples in 198 patients who were diagnosed with World Health Organization group I PAH from January 2002 through January 2009. At time of diagnosis median NT-pro-BNP levels were significantly different between survivors (610 pg/ml, range 6 to 8,714) and nonsurvivors (2,609 pg/ml, range 28 to 9,828, p <0.001). In addition, NT-pro-BNP was significantly associated (p <0.001) with other parameters of disease severity (6-minute walking distance, functional class). Receiver operating curve analysis identified ≥1,256 pg/ml as the optimal NT-pro-BNP cutoff for predicting mortality at time of diagnosis. Serial measurements allowed calculation of baseline NT-pro-BNP (i.e., intercept obtained by back-extrapolation of concentration-time graph), providing a better discrimination between survivors and nonsurvivors than NT-pro-BNP at time of diagnosis alone (p = 0.010). Furthermore, a decrease of NT-pro-BNP of >15%/year was associated with survival. In conclusion, a serum NT-pro-BNP level ≥1,256 pg/ml at time of diagnosis identifies poor outcome in patients with PAH. In addition, a decrease in NT-pro-BNP of >15%/year is associated with survival in PAH. SN - 1879-1913 UR - https://www.unboundmedicine.com/medline/citation/21890089/Usefulness_of_serial_N_terminal_pro_B_type_natriuretic_peptide_measurements_for_determining_prognosis_in_patients_with_pulmonary_arterial_hypertension_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9149(11)02303-4 DB - PRIME DP - Unbound Medicine ER -