Mid‐regional pro‐atrial natriuretic peptide for the early detection of non‐acute heart failure

Gohar, Aisha; Rutten, Frans H.; Ruijter, Hester M. den; Kelder, Johannes C.; Haehling, Stephan von; Anker, Stefan D.; Möckel, Martin; Hoes, Arno W.

doi:10.1002/ejhf.1495

Cited by 30 publications

(23 citation statements)

References 43 publications

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“…Rather, HF may have been undiagnosed in women more often than men, because of differences in distributions of HF types between men and women. HFrEF is the most common type in men whereas HFpEF is the most common type among women [21], and particularly HFpEF can remain undiagnosed compared to HFrEF [22]. This may have resulted in HF cases in the group of non-cases, specifically in women, resulting in diluted associations.…”

Section: Discussionmentioning

confidence: 99%

The association of the Mediterranean diet with heart failure risk in a Dutch population

Strengers

Ruijter

Boer

et al. 2021

Nutrition, Metabolism and Cardiovascular Diseases

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Background and aims: It is still unclear whether a healthy diet can prevent heart failure (HF). Therefore, this study aimed to investigate the association between adherence to a Mediterranean-style diet, reflected by modified Mediterranean Diet Scores (mMDS), and the incidence of HF in men and women. Methods and results: This observational study comprised 9316 men and 27,645 women from the EPIC-NL cohort free from cardiovascular disease at baseline. Dietary intakes were assessed using a validated food frequency questionnaire. mMDS was calculated using a 9-point scale based on consumption of vegetables, legumes, fruit, nuts, seeds, grains, fish, fat ratio, dairy, meat and alcohol. HF events were ascertained by linkage to nationwide registries. Multivariable Hazard Ratios (HR) and 95% confidence intervals (CI) were estimated by Cox proportional hazards regression models. Over a median follow-up of 15 years (IQR 14e16), 633 HF events occurred: 144 in men (1.5%) and 489 in women (1.8%). The median mMDS was 4 (IQR 3e5). There was significant effect modification by sex (P-value for interaction <0.001), therefore results are stratified for men and women. For men, a higher mMDS associated with lower HF risk (HR: 0.88; 95% CI: 0.79, 0.98 per point increase in mMDS; HR upper category: 0.53; 95% CI: 0.33, 0.86), whereas no association was found in women (HR: 0.98; 95% CI: 0.93, 1.04 per point increase; HR upper category: 1.07; 95% CI: 0.83, 1.36). Conclusion: Adherence to a Mediterranean-style diet may reduce HF risk, particularly in men. The underlying reasons for the differences in findings between men and women need further study.

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Section: Discussionmentioning

confidence: 99%

The association of the Mediterranean diet with heart failure risk in a Dutch population

Strengers

Ruijter

Boer

et al. 2021

Nutrition, Metabolism and Cardiovascular Diseases

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“…Gohar et al 7 evaluated the diagnostic role of mid-regional pro-atrial natriuretic peptide (MR-proANP) in patients with signs and symptoms suggestive of HF. The diagnosis was done by expert physicians, using all available data, including natriuretic peptides and echocardiography, blinded to biomarker results.…”

Section: Diagnosis Early Diagnosismentioning

confidence: 99%

October 2019 at a glance: epidemiology, prevention, and modes of death

Adamo

Lombardi

Metra

2019

European J of Heart Fail

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Heart Failure Association consensus meeting report Update on heart failure Important changes occurred since the publication of the last guidelines on heart failure (HF). Seferovic et al. 1 summarized in a consensus document the major advances that occurred in HF treatment. These include the effects of sodium-glucose co-transporter 2 inhibitors in type 2 diabetes mellitus, MitraClip for functional mitral regurgitation, atrial fibrillation (AF) ablation in HF, tafamidis in cardiac transthyretin amyloidosis, rivaroxaban in HF in sinus rhythm, implantable cardioverter-defibrillators (ICD) in non-ischaemic HF and telemedicine. Epidemiology and prevention Geographic differences Tromp et al. 2 reviewed geographic differences in aetiology, co-morbidities, use of guideline-directed medical therapies, use of devices and outcomes, among HF patients from different geographic areas. They reported also the role of socioeconomic determinants, such as country income level and out-of-pocket costs, for quality of care and clinical outcomes across different countries.

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“…Also, MR-proANP has been shown to be associated with clinical outcomes in HFpEF, not HF with reduced ejection fraction (HFrEF), [ 9 ] and in an at-risk community population, NT-proBNP and MR-proANP have shown to predict incident HF [ 10 ]. Moreover, MR-proANP levels have shown similar diagnostic performance as NT-proBNP in primary care patients suspected of non-acute HF [ 11 ]. And in a high-risk population such as outpatients with T2D, our group recently reported, that MR-proANP with a cut-off of less than 60 pmol/l was efficient to rule out HFrEF and at this cut-off, the highest ability to similarly rule out HFpEF was obtained.…”

Section: Introductionmentioning

confidence: 99%

MR-proANP and incident cardiovascular disease in patients with type 2 diabetes with and without heart failure with preserved ejection fraction

Jensen

Schou

Kistorp

et al. 2020

Cardiovasc Diabetol

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Background Mid-regional pro-atrial natriuretic peptide (MR-proANP) is a useful biomarker in outpatients with type 2 diabetes (T2D) to diagnose heart failure (HF). Elevated B-type natriuretic peptides are included in the definition of HF with preserved ejection fraction (HFpEF) but little is known about the prognostic value of including A-type natriuretic peptides (MR-proANP) in the evaluation of patients with T2D. Methods We prospectively evaluated the risk of incident cardiovascular (CV) events in outpatients with T2D (n = 806, mean ± standard deviation age 64 ± 10 years, 65% male, median [interquartile range] duration of diabetes 12 [6–17] years, 17.5% with symptomatic HFpEF) according to MR-proANP levels and stratified according to HF-status including further stratification according to a prespecified cut-off level of MR-proANP. Results A total of 126 CV events occurred (median follow-up 4.8 [4.1–5.3] years). An elevated MR-proANP, with a cut-off of 60 pmol/l or as a continuous variable, was associated with incident CV events (p < 0.001). Compared to patients without HF, patients with HFpEF and high MR-proANP (≥ 60 pmol/l; median 124 [89–202] pmol/l) and patients with HF and reduced ejection fraction (HFrEF) had a higher risk of CV events (multivariable model; hazard ratio (HR) 2.56 [95% CI 1.64–4.00] and 3.32 [1.64–6.74], respectively). Conversely, patients with HFpEF and low MR-proANP (< 60 pmol/l; median 46 [32–56] pmol/l) did not have an increased risk (HR 2.18 [0.78–6.14]). Conclusions Patients with T2D and HFpEF with high MR-proANP levels had an increased risk for CV events compared to patients with HFpEF without elevated MR-proANP and compared to patients without HF, supporting the use of MR-proANP in the definition of HFpEF from a prognostic point-of-view.

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Mid‐regional pro‐atrial natriuretic peptide for the early detection of non‐acute heart failure

Cited by 30 publications

References 43 publications

The association of the Mediterranean diet with heart failure risk in a Dutch population

The association of the Mediterranean diet with heart failure risk in a Dutch population

October 2019 at a glance: epidemiology, prevention, and modes of death

MR-proANP and incident cardiovascular disease in patients with type 2 diabetes with and without heart failure with preserved ejection fraction

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