Title of article :
Comparison of Midregional Pro-Atrial Natriuretic Peptide With N-Terminal Pro-B-Type Natriuretic Peptide in Predicting Survival in Patients With Chronic Heart Failure Original Research Article
Author/Authors :
Stephan von Haehling، نويسنده , , Ewa A. Jankowska، نويسنده , , Nils G. Morgenthaler، نويسنده , , Corrado Vassanelli، نويسنده , , Luisa Zanolla، نويسنده , , Piotr Rozentryt، نويسنده , , Gerasimos S. Filippatos، نويسنده , , Wolfram Doehner، نويسنده , , Friedrich Koehler، نويسنده , , Jana Papassotiriou، نويسنده , , Dimitrios T. Kremastinos، نويسنده , , Waldemar Banasiak، نويسنده , , Joachim Struck، نويسنده , , Piotr Ponikowski، نويسنده , , Andreas Bergmann، نويسنده , , Stefan D. Anker، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 2007
Pages :
8
From page :
1973
To page :
1980
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 funcitonal 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 ≥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.
Keywords :
heart failure , ROC , AUC , Hf , NYHA , New York Heart Association , LVEF , left ventricular ejection fraction , NT-proBNP , N-terminal pro-B-type natriuretic peptide , receiver-operating characteristic , area under the receiver-operating characteristic curve , MR-proANP , midregional pro-atrial natriuretic peptide
Journal title :
JACC (Journal of the American College of Cardiology)
Serial Year :
2007
Journal title :
JACC (Journal of the American College of Cardiology)
Record number :
472921
Link To Document :
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