Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia

Sabatine, Marc S.; Morrow, David A.; Lemos, James A. de; Omland, Torbjørn; Desai, Milind Y.; Tanasijevic, Milenko J.; Hall, Christian; McCabe, Carolyn H.; Braunwald, Eugene

doi:10.1016/j.jacc.2004.07.057

Cited by 307 publications

(229 citation statements)

References 23 publications

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“…Sabatin et al and Foote et al . also reported similar results 32,33. On the other hand, other studies reported contradictory findings 34,35.…”

Section: Discussionmentioning

confidence: 61%

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

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AimThe aim of this study was to detect any relationship between serum high-sensitivity C-reactive protein (hs-CRP), serum amyloid-associated protein (SAA) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels, and reversible myocardial ischaemia during cardiovascular exercise tests and to determine whether these biomarkers could predict transient myocardial ischaemia.MethodsNinety-six patients (36 women, 60 men, mean age 57 ± 8.5 years) were included in the study. Venous blood samples were taken from patients before and 15 minutes after exercise testing. SAA and hs-CRP were analysed using immunonephelometric assays (Dade-Behring, BN II, Marburg, Germany). NT-proBNP (pg/ml) was determined using the immulite 1 000 chemiluminescence immunoassay system (Siemens Medical Solution Diagnostics, Deerfiled, USA). Forty-eight patients (18 women, 30 men) with positive exercise tests were allocated to the exercise-positive group and 48 (18 women, 30 men) with negative exercise tests were put in the exercise-negative group. Coronary angiography was performed on all patients in the exercise-positive group.ResultsThere was no difference between the levels of hs-CRP, SAA and NT-pro-BNP before and after exercise testing in both of the exercise groups.ConclusionSerum levels of hs-CRP, SAA and NT-proBNP could not predict the occurrence of reversible myocardial ischaemia during exercise. Large-scale clinical studies are needed to clarify the status of hs-CRP, SAA and NT-proBNP with exercise.

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“…Sabatin et al and Foote et al . also reported similar results 32,33. On the other hand, other studies reported contradictory findings 34,35.…”

Section: Discussionmentioning

confidence: 61%

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Başkurt¹,

Aktürk²,

Keskin³

et al. 2011

CardioVascular Journal of Africa

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“…This ability could be attributed to higher levels of natriuretic peptides in patients with asymptomatic myocardial ischemia15, 16 and paroxysmal atrial fibrillation,17, 18 which could predispose to both MI and stroke.…”

Section: Discussionmentioning

confidence: 99%

“…However, as the incidences of outcomes differ between patients with HF8 and patients with a recent ACS9 in a stable phase, it is less established how natriuretic peptides are associated with cardiovascular outcomes, especially subsequent MI and stroke, in the latter population 3, 10, 11, 12, 13, 14. Concentrations of natriuretic peptides may be affected by both asymptomatic myocardial ischemia15, 16 and atrial fibrillation,17, 18 which could make BNP and NT‐proBNP relevant as predictors of MI and stroke. However, trials investigating patients at high risk of atherosclerotic events have found conflicting results regarding both the predictive ability of natriuretic peptides and cardiovascular outcomes—including MI and stroke—as well as the predictive strength of BNP versus NT‐proBNP 19, 20, 21, 22…”

Section: Introductionmentioning

confidence: 99%

Role of B‐Type Natriuretic Peptide and N‐Terminal Prohormone BNP as Predictors of Cardiovascular Morbidity and Mortality in Patients With a Recent Coronary Event and Type 2 Diabetes Mellitus

Wolsk

Claggett

Pfeffer

et al. 2017

JAHA

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BackgroundNatriuretic peptides are recognized as important predictors of cardiovascular events in patients with heart failure, but less is known about their prognostic importance in patients with acute coronary syndrome. We sought to determine whether B‐type natriuretic peptide (BNP) and N‐terminal prohormone B‐type natriuretic peptide (NT‐proBNP) could enhance risk prediction of a broad range of cardiovascular outcomes in patients with acute coronary syndrome and type 2 diabetes mellitus.Methods and ResultsPatients with a recent acute coronary syndrome and type 2 diabetes mellitus were prospectively enrolled in the ELIXA trial (n=5525, follow‐up time 26 months). Best risk models were constructed from relevant baseline variables with and without BNP/NT‐proBNP. C statistics, Net Reclassification Index, and Integrated Discrimination Index were analyzed to estimate the value of adding BNP or NT‐proBNP to best risk models. Overall, BNP and NT‐proBNP were the most important predictors of all outcomes examined, irrespective of history of heart failure or any prior cardiovascular disease. BNP significantly improved C statistics when added to risk models for each outcome examined, the strongest increments being in death (0.77–0.82, P<0.001), cardiovascular death (0.77–0.83, P<0.001), and heart failure (0.84–0.87, P<0.001). BNP or NT‐proBNP alone predicted death as well as all other variables combined (0.77 versus 0.77).ConclusionsIn patients with a recent acute coronary syndrome and type 2 diabetes mellitus, BNP and NT‐proBNP were powerful predictors of cardiovascular outcomes beyond heart failure and death, ie, were also predictive of MI and stroke. Natriuretic peptides added as much predictive information about death as all other conventional variables combined.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01147250.

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“…Despite careful patient selection, occult myocardial ischemia, which may raise circulating NP levels (42), cannot be ruled out in some of our CKD patients. Intensive screening for coronary artery disease was not systematically performed as all patients were free of symptoms or signs of cardiovascular disease.…”

Section: Limitationsmentioning

confidence: 97%

Natriuretic Peptides in Chronic Kidney Disease

Tagore

Ling

Yang

et al. 2008

Clinical Journal of the American Society of Nephrology

100

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Background and objectives: B-type natriuretic peptide (BNP) and amino-terminal pro-B-type natriuretic peptide (NTproBNP) are biomarkers of cardiovascular disease that is common in patients with chronic kidney disease (CKD). Conflicting data on the influence of glomerular filtration rate (GFR) on BNP and NT-proBNP levels in CKD may stem from failure to account fully for the effects of coexistent cardiac disease, dysfunction, and volume overload.Design, setting, participants, & measurements: Prospective head-to-head comparison of plasma BNP and NT-proBNP in ambulatory euvolemic CKD patients with normal LV ejection fraction and no manifest cardiac or vascular disease. GFR was estimated by the Modification of Diet in Renal Disease formula, BNP and NT-proBNP measured using Abbott AxSYM and Roche Elecsys assays, respectively, and cardiac morphology and function assessed by transthoracic echocardiography.Results: In 142 patients (42% female) of mean age 60 ؎ 11 yr, mean left ventricular ejection fraction was 71% ؎ 6%, GFR 38 ؎ 14 ml/min per 1.73 m 2 , and median BNP and NT-proBNP level 59 and 311 pg/ml, respectively. Multivariate predictors of NT-proBNP level were GFR, ␤-blocker usage, LV mass index, and hemoglobin level. Plasma BNP was independently predicted by LV mass index and ␤-blocker usage but not GFR. In the 74 patients without diastolic dysfunction, there was a significant rise in NT-proBNP but not BNP as GFR declined.Conclusions: Unlike NT-proBNP, plasma BNP level is relatively independent of GFR. BNP may therefore be the more appropriate biomarker to screen for cardiac dysfunction in CKD.

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Acute changes in circulating natriuretic peptide levels in relation to myocardial ischemia

Cited by 307 publications

References 23 publications

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Serum high-sensitivity C-reactive protein, amyloid-associated protein and N-terminal proBNP levels do not predict reversible myocardial ischaemia

Role of B‐Type Natriuretic Peptide and N‐Terminal Prohormone BNP as Predictors of Cardiovascular Morbidity and Mortality in Patients With a Recent Coronary Event and Type 2 Diabetes Mellitus

Natriuretic Peptides in Chronic Kidney Disease

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