Brain natriuretic peptide predicts mortality in the elderly.

Wallén, Thomas; Landahl, Sten; Hedner, Thomas; Nakao, Kazuwa; Saito, Yoshihiko

doi:10.1136/hrt.77.3.264

Cited by 155 publications

(95 citation statements)

References 18 publications

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“…In chronic heart failure, there are few studies regarding the prognostic value of plasma ANP [11]. One was performed in an elderly population [12] and the other study by Gottlieb et al [22] showed that plasma ANP, but not left ventricular ejection fraction, was prognostically important. To date, no study has addressed the prognostic value of plasma BNP in a cohort of patients with recent onset heart failure.…”

Section: Discussionmentioning

confidence: 99%

“…In th,e past decade, the prognostic value of natriuretic peptides has been confirmed in various diseases including acute myocardial infarction [9,10], and chronic heart failure [11] and even in a recent study of a community-based elderly population without car- [59][60][61][62][63][64][65] diovascular disease [12]. However, the prognostic importance of BNP and ANP in acute heart failure has not been addressed.…”

Section: Introductionmentioning

confidence: 99%

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Plasma brain natriuretic peptide — an independent predictor of cardiovascular mortality in acute heart failure

Sanderson

1999

European J of Heart Fail

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Purpose: To examine the prognostic importance of both plasma atrial natriuretic and B-(brain natriuretic peptide) following an episode of acute heart failure. Subjects and methods: A prospective cohort of 91 patients admitted into hospital with acute heart failure were recruited. After initial in-hospital management plasma ANP and BNP levels were measured by radioimmunoassay, and echocardiography was performed on the same day. Patients were followed up for 12 months and the main outcome measure was cardiovascular death. Results: Plasma ANP and BNP levels were significantly higher in patients who died of a cardiovascular cause within 12 months (P < 0.001 and P < (1.0001, respectively) or at I-month (P < 0.05 and P < 0.001) after recruitment. By Kaplan-Meier estimated life-table curves, patients with above median plasma ANP or BNP levels had significantly higher I-year mortality (42.5% vs. 11.6%, both P < 0.005). By multivariate Cox proportional hazard regression analysis, the plasma BNP level was the most important prognostic factor predicting mortality (X 2 = 18.3, P < 0.0001), followed by age (X2 = 11.5, P < 0.001). Other factors mcluding ANP, left ventricular ejection fraction by M-mode echocardiography, pulmonary arterial pressure, sex, cause of heart failure as well as New York Heart Association class were not significant. Conclusion: A plasma BNP level has independent and at least short-term prognostic significance in patients admitted with acute heart failure. This non-invasive and readily available blood test should be considered for risk stratification in patients with acute heart failure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Plasma brain natriuretic peptide — an independent predictor of cardiovascular mortality in acute heart failure

Sanderson

1999

European J of Heart Fail

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“…Plasma BNP predicted 5-year mortality better than ANP and NT-proANP in the total population as well as in individuals without a defined cardiovascular disorder (92,109 ).…”

Section: Prognosis In Acsmentioning

confidence: 99%

“…Wallen et al (92,109 ) studied whether prospective measurements of circulating concentrations of ANP, NTproANP, and BNP could predict mortality in a cohort of 85-year-old individuals from the general population (n ϭ 541), who were followed up prospectively for 5 years. Plasma BNP predicted 5-year mortality better than ANP and NT-proANP in the total population as well as in individuals without a defined cardiovascular disorder (92,109 ).…”

Section: Prognosis In Acsmentioning

confidence: 99%

Diagnostic Accuracy and Prognostic Relevance of the Measurement of Cardiac Natriuretic Peptides: A Review

2004

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Background:The pathophysiologic and clinical relevance of cardiac natriuretic hormone (CNH) assays has been investigated in numerous experimental and clinical studies. Authors have sought to evaluate the diagnostic accuracy and prognostic relevance of the measurement of CNHs according to evidence-based laboratory medicine principles. Methods: In June 2003, we ran a computerized literature search on National Library of Medicine using keywords "ANP" and "BNP" and found more than 12 300 and 1200 articles, respectively. A more refined search with keywords "ANP or BNP assay" extracted ϳ7000 and 800 articles, respectively. Only studies specifically designed to evaluate the diagnostic accuracy and prognostic relevance of CNH measurements were selected from this huge mass of articles to be discussed in this review. Content: Several studies suggested that CNH assays may be clinically useful for the screening and classification of patients with heart failure, as a prognostic marker in cardiovascular disease, in the follow-up of patients with heart failure, and because they may reduce the need for further cardiac investigation. However, it is difficult to compare even the best-designed studies because not only did the authors evaluate different populations, they also used different gold standards. Conclusions: CNH assays and conventional diagnostic work-ups provide complementary information for evaluation of the presence and severity of cardiac dysfunction and clinical disease. Several aspects of CNH assays are still to be elucidated, and further work is needed to

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“…Increased plasma BNP or serum NT-proBNP levels are useful biomarkers for prediction of high risks for any cause mortality in the general population. [15][16][17] However, few clinical studies have shown significant relationship between low plasma BNP and CVD risk. A communitybased study indicated that BNP levels, even if these are within a normal range, predicted the risk of death and cardiovascular events including heart failure in a population consisting of mainly Caucasian and living in Framingham.…”

Section: Discussionmentioning

confidence: 99%

Effects of Statins on Left Ventricular Diastolic Function in Patients with Dyslipidemia and Diastolic Dysfunction (Stat-LVDF Study)

Morimoto

Sunagawa

Hirano

et al. 2015

Biological & Pharmaceutical Bulletin

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Statins, 3-hydroxy-3-methylglutaryl (HMG)-CoA reductase inhibitors, are potential drugs for chronic heart failure treatment in clinical studies. However, there may be differences in the effects on heart failure between lipophilic and hydrophilic statins. In this study, we investigated whether hydrophilic rosuvastatin (RSV) and lipophilic pitavastatin (PTV) exert different effects on the left ventricular diastolic function. Subjects were hypercholesterolemia patients with left ventricular diastolic dysfunction. This was an open-label, randomized, parallel, comparative, prospective study. The subjects received treatment with RSV or PTV for 24 weeks, and their low density lipoprotein (LDL)-cholesterol levels were controlled by these statins according to the guideline. The primary endpoint was defined as the change in left ventricle (LV) diastolic function (E/E′) estimated by echocardiography, and the secondary endpoint was the plasma B-type natriuretic peptide (BNP) level. No serious adverse effects were observed during the entire study period in any patient, nor were there any significant differences in changes in the body mass index, blood pressure, or heart rate. Statin treatment did not significantly alter the primary endpoint, E/E′. The change ratio of BNP was not significantly different between PTV and RSV groups. However, BNP was significantly increased in the RSV (p 0.030) but not the PTV ( p>0.999) group. This study revealed that although neither RSV nor PTV improved LV diastolic dysfunction, BNP, a biomarker of LV wall stress, was increased in the RSV but not the PTV group. Observation for a longer period is necessary to clarify the different effects of these statins on LV diastolic dysfunction. (UMIN-ID: UMIN000003571).Key words lipophilic statin; hydrophilic statin; diastolic function; dyslipidemia Heart failure is the end stage of various forms of heart disease and exhibits common clinical symptoms, regardless of the underlying pathology.1,2) Heart failure severely impacts a patient's daily life and shortens the patient's life-span. 3-Hydroxy-3-methylglutaryl (HMG)-CoA reductase inhibitors are drugs that inhibit cholesterol synthesis in the liver and that lower serum cholesterol. Previous large-scale clinical trials have found that HMG-CoA reductase inhibitors provide primary and secondary prophylaxis against cardiovascular events. Moreover, the latest studies have reported that statins exhibit a range of actions unrelated to lowering cholesterol (such as anti-inflammatory action, anti-oxidant action, and action to inhibit the renin-angiotensin system).3) Hydrophilic statins have difficulty entering tissue because of their physical characteristics, but lipophilic statins readily penetrate tissue. Thus, lipophilic statins may be better able to exhibit a range of actions (i.e., pleiotropic effects). Rosuvastatin (RSV) is a hydrophilic statin, and large-scale clinical trials have found that RSV did not improve the prognosis for patients with heart failure. 4,5) In contrast, other trials have suggested tha...

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Brain natriuretic peptide predicts mortality in the elderly.

Cited by 155 publications

References 18 publications

Plasma brain natriuretic peptide — an independent predictor of cardiovascular mortality in acute heart failure

Plasma brain natriuretic peptide — an independent predictor of cardiovascular mortality in acute heart failure

Diagnostic Accuracy and Prognostic Relevance of the Measurement of Cardiac Natriuretic Peptides: A Review

Effects of Statins on Left Ventricular Diastolic Function in Patients with Dyslipidemia and Diastolic Dysfunction (Stat-LVDF Study)

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