Plasma brain natriuretic peptide concentrations and the risk of cardiovascular events and death in general practice

Tsuchida, Keizo; Tanabe, Kazuhiko

doi:10.1016/j.jjcc.2008.07.007

Cited by 30 publications

(23 citation statements)

References 29 publications

(42 reference statements)

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“…9 Another clinical observational study in Japan also revealed a significant influence of elevated BNP levels on CVD events, but this association was not observed for coronary heart disease. 22 The present study confirmed the results from the prior studies and provided more detailed information regarding the risks of various CVDs, including coronary heart disease and stroke. To the best of our knowledge, this is the first report to show that elevated NT-proBNP levels are an independent risk factor for the occurrence of intracerebral hemorrhage.…”

Section: Discussionsupporting

confidence: 90%

“…6,7,9,11 However, very few prospective studies have provided evidence of associations between the natriuretic peptide levels and CVD in Asian populations. 9,22 One cohort study of a Japanese population showed an association between increased BNP levels and the risk of developing ischemic stroke. 9 Another clinical observational study in Japan also revealed a significant influence of elevated BNP levels on CVD events, but this association was not observed for coronary heart disease.…”

Section: Discussionmentioning

confidence: 99%

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N-Terminal Pro-Brain Natriuretic Peptide and Risk of Cardiovascular Events in a Japanese Community

Doi

Ninomiya

Hata

et al. 2011

ATVB

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Objective-Few studies have examined the association between natriuretic peptides and the incidence of cardiovascular disease (CVD) in Asian populations. Methods and Results-A total of 3104 community-dwelling Japanese individuals aged Ն40 years without history of CVD were followed up for 5 years. A total of 127 CVD events were identified. The age-and sex-adjusted incidence of CVD increased with increasing N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (Ͻ55, 55-124, 125-399, and Ն400 pg/mL) at baseline and was significantly higher even in subjects with a modest increase. The multivariate-adjusted hazard ratios for the development of total CVD and its subtypes, coronary heart disease and stroke, were significantly increased by a 1 SD increment of the log NT-proBNP concentrations and were nearly equal among CVD subtypes. Similar findings were observed for stroke subtypes of ischemic stroke and intracerebral hemorrhage but not subarachnoid hemorrhage. The effects of the 1 SD increment in log NT-proBNP values were comparable in subjects with and without other cardiovascular risk factors, except for sex.The area under the receiver operating characteristic curve was significantly (Pϭ0.006) increased by adding NT-proBNP values to the model including other potential risk factors. Conclusion-Elevated NT-proBNP levels were shown to be a significant risk factor for the development of CVD and its subtypes in a general Japanese population, independently of other cardiovascular risk factors.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

N-Terminal Pro-Brain Natriuretic Peptide and Risk of Cardiovascular Events in a Japanese Community

Doi

Ninomiya

Hata

et al. 2011

ATVB

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“…Twenty-three studies were based in Europe, 8 -28,46,47 5 in North America, 29 -33 1 in Australia and New Zealand, 34 and 7 in East Asia [35][36][37][38][39][40]45 (predominantly in Japan), and 4 were multinational. [41][42][43][44] Thirty-six studies were prospective cohorts and 4 "nested" case-control studies; 14 studies recruited participants from population registers (such as general practitioners' lists or electoral rolls), and 26 were hospital based (of which 10 were clinical trials).…”

Section: Resultsmentioning

confidence: 99%

B-Type Natriuretic Peptides and Cardiovascular Risk

et al. 2009

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Background-Measurement of B-type natriuretic peptide (BNP) concentration or its precursor (N-terminal fragment [NT-proBNP]) is recommended in patients with symptoms of left ventricular dysfunction and in other settings, but the relevance of these peptides to cardiovascular disease (CVD) in general populations or in patients with stable vascular disease is uncertain. Methods and Results-Data were collated from 40 long-term prospective studies involving a total of 87 474 participants and 10 625 incident CVD outcomes. In a comparison of individuals in the top third with those in the bottom third of baseline values of natriuretic peptides, the combined risk ratio (RR), adjusted for several conventional risk factors, was 2.82 (95% confidence interval [CI], 2.40 to 3.33) for CVD. Analysis of the 6 studies with at least 250 CVD outcomes (which should be less prone to selective reporting than are smaller studies) yielded an adjusted RR of 1. Key Words: cardiovascular diseases Ⅲ meta-analysis Ⅲ natriuretic peptides B -type natriuretic peptide (BNP) is a 32-amino acid polypeptide secreted by ventricular myocytes during periods of increased ventricular stretch and wall tension. This peptide is believed to play an important role in the regulation of blood pressure, blood volume, and sodium balance. On secretion, the BNP precursor is split into the biologically active peptide and the more stable N-terminal fragment (NT-proBNP). 1,2 Measurement of circulating levels of BNP or NT-proBNP has been recommended in the diagnosis and prognosis of patients with symptoms of left ventricular dysfunction 3 and for stratification of risk in patients with acute coronary syndromes. 4,5 Because in vitro studies have reported that natriuretic peptides are directly released from cardiomyocytes in response to myocardial ischemia, 6,7 it has been proposed that their circulating levels are relevant to subsequent risk of cardiovascular diseases (CVDs) other than heart failure. Clinical Perspective on p 2187Although many prospective studies have investigated concentrations of natriuretic peptides in relation to the subsequent risk of CVD (eg, coronary heart disease [CHD] or stroke), most of them have not been systematically assessed. 8 -47 Two previous relevant reviews (in total involving 11 studies 48,49 ) involved only about one sixth of the currently available data. Interpretation of the evidence has been complicated by studies that have involved different markers (ie, BNP, NT-proBNP, or both), populations with different base- We report an updated meta-analysis of findings from 40 long-term prospective studies of BNP and NT-proBNP involving a total of 87 474 individuals, including 10 625 incident CVD outcomes, in 3 distinct groups: participants from approximately general populations, people selected on the basis of elevated CVD risk factors, and patients with stable CVD at study entry. Methods Study SelectionWe sought prospective studies that had been published before July 2009 and reported on associations of circulating BNP and/or NTproBNP w...

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“…BNP on admission was higher in patients than in controls (25 vs 13 pg/ml, p=0.01) and it decreased to 16 pg/ml pre-discharge (p=0.0002). Another study in patients with septic shock, demonstrated that both BNP and ANP peaked on day 2 (BNP, 987 ± 160 pg/ml; ANP, 103 ± 17 pg/ml) (control group: BNP, 7 ± 0.3 pg/ml; ANP, 13 ± 1 pg/ml) [79].…”

Section: Plasma Levels Of Natriuretic Peptides In Septic Patientsmentioning

confidence: 99%

Natriuretic Peptides in Septic Patients

Piechota

Barylski²,

Hannam³

et al. 2009

CMC

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The natriuretic peptide family is comprised of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), dendroaspis natriuretic peptide - DNP and urodilatin. They play a role in the diagnosis of several diseases, especially those involving the cardiovascular system. Sepsis is a complex condition that can lead to multiorgan failure, shock and death. The number of people developing sepsis is still increasing (approximately 750,000 cases of sepsis occur annually in the USA). Both ANP and pro-ANP have attracted interest as new markers for sepsis. Reports indicate that ANP or BNP levels are elevated in septic patients. However, many mechanisms are still unexplained. This situation is complicated by the fact that contradictory results have been published. There are several reasons for this controversy including differences in the techniques used to assay natriuretic peptides. Nevertheless, natriuretic peptides might eventually prove useful for the diagnosis and/or the treatment of septic patients.

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Plasma brain natriuretic peptide concentrations and the risk of cardiovascular events and death in general practice

Abstract: In general practice, BNP levels predicted the risk of cardiovascular events other than coronary heart disease events and of death.

Cited by 30 publications

References 29 publications

N-Terminal Pro-Brain Natriuretic Peptide and Risk of Cardiovascular Events in a Japanese Community

N-Terminal Pro-Brain Natriuretic Peptide and Risk of Cardiovascular Events in a Japanese Community

B-Type Natriuretic Peptides and Cardiovascular Risk

Natriuretic Peptides in Septic Patients

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