Plasma Concentration of Amino-Terminal Pro-Brain Natriuretic Peptide in Chronic Heart Failure: Prediction of Cardiovascular Events and Interaction With the Effects of Rosuvastatin

Cleland, John G.F.; McMurray, John J.V.; Kjekshus, John; Cornel, Jan H.; Dunselman, Peter H.J.M.; Fonseca, Cândida; Hjalmarson, Åke; Korewicki, J; Lindberg, Magnus; Ranjith, Naresh; Veldhuisen, Dirk J. van; Waagstein, Finn; Wedel, Hans; Wikstrand, John

doi:10.1016/j.jacc.2009.06.041

Cited by 198 publications

(135 citation statements)

References 26 publications

Supporting

Mentioning

116

Contrasting

Unclassified

Order By: Relevance

“…Elevated levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin T (TnT) are associated with adverse outcomes, including incident heart failure (HF), major cardiovascular events, and mortality (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). NT-proBNP is secreted into the circulation from cardiac myocytes in response to stimuli, such as pressure or volume overload (13).…”

Section: Introductionmentioning

confidence: 99%

NT-ProBNP and Troponin T and Risk of Rapid Kidney Function Decline and Incident CKD in Elderly Adults

Bansal

Katz

Dalrymple

et al. 2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

Background and objectives Elevations in N-terminal pro-B-type natriuretic peptide and high-sensitivity troponin T are associated with poor cardiovascular outcomes. Whether elevations in these cardiac biomarkers are associated with decline in kidney function was evaluated.Design, setting, participants, & measurements N-terminal pro-B-type natriuretic peptide and troponin T were measured at baseline in 3752 participants free of heart failure in the Cardiovascular Health Study. eGFR was determined from the Chronic Kidney Disease Epidemiology Collaboration equation using serum cystatin C. Rapid decline in kidney function was defined as decline in serum cystatin C eGFR$30%, and incident CKD was defined as the onset of serum cystatin C eGFR,60 among those without CKD at baseline (n=2786). Cox regression models were used to examine the associations of each biomarker with kidney function decline adjusting for demographics, baseline serum cystatin C eGFR, diabetes, and other CKD risk factors.Results In total, 503 participants had rapid decline in serum cystatin C eGFR over a mean follow-up time of 6.41 (1.81) years, and 685 participants developed incident CKD over a mean follow-up time of 6.41 (1.74) years. Participants in the highest quartile of N-terminal pro-B-type natriuretic peptide (.237 pg/ml) had an 67% higher risk of rapid decline and 38% higher adjusted risk of incident CKD compared with participants in the lowest quartile (adjusted hazard ratio for serum cystatin C eGFR rapid decline, 1.67; 95% confidence interval, 1.25 to 2.23; hazard ratio for incident CKD, 1.38; 95% confidence interval, 1.08 to 1.76). Participants in the highest category of troponin T (.10.58 pg/ml) had 80% greater risk of rapid decline compared with participants in the lowest category (adjusted hazard ratio, 1.80; 95% confidence interval, 1.35 to 2.40). The association of troponin T with incident CKD was not statistically significant (hazard ratio, 1.17; 95% confidence interval, 0.92 to 1.50).Conclusions Elevated N-terminal pro-B-type natriuretic peptide and troponin T are associated with rapid decline of kidney function and incident CKD. Additional studies are needed to evaluate the mechanisms that may explain this association.

show abstract

Section: Introductionmentioning

confidence: 99%

NT-ProBNP and Troponin T and Risk of Rapid Kidney Function Decline and Incident CKD in Elderly Adults

Bansal

Katz

Dalrymple

et al. 2015

Clinical Journal of the American Society of Nephrology

View full text Add to dashboard Cite

show abstract

“…A previous post hoc analysis of the I‐PRESERVE trial in patients with heart failure showed that, although NT‐proBNP independently predicted all‐cause mortality and cardiovascular hospitalizations, the response to ARB therapy was attenuated with higher NT‐proBNP levels 18. Additionally, the efficacy of statins in patients with elevated cardiovascular risk also appears to be higher in patients with lower NT‐proBNP levels, although the mechanisms by which statin treatment would be more beneficial in patients with low NT‐proBNP are incompletely understood 19, 20. The present study extends these previous findings to a broad population of patients with type 2 diabetes with or without cardiovascular disease and varying levels of kidney function and albuminuria.…”

Section: Discussionmentioning

confidence: 99%

N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) predicts the cardio‐renal response to aliskiren in patients with type 2 diabetes at high renal and cardiovascular risk

Idzerda

Persson

Pena

et al. 2018

Diabetes Obesity Metabolism

View full text Add to dashboard Cite

Sodium retention and volume overload are the main determinants of poor response to renin‐angiotensin‐aldosterone system (RAAS) inhibition in patients with diabetes. As volume excess can exist without symptoms, biomarkers are needed to identify a priori which patients are volume overloaded and may experience less benefit from RAAS inhibition. N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) is released in the setting of increased cardiac wall stress and volume overload. We conducted a post hoc analysis among 5081 patients with type 2 diabetes mellitus participating in the ALTITUDE trial to investigate whether NTproBNP can predict the effects of additional therapy with aliskiren on cardio‐renal endpoints. Aliskiren compared to placebo reduced the risk of the primary cardio‐renal endpoint events by 20% (95% confidence interval [CI] 16 to 61) and 2% (95% CI –42 to 30) in the two lowest NT‐proBNP tertiles, and it increased the risk by 25% (95% CI –4 to 96) in the highest NT‐proBNP tertile (P value for trend = 0.009). Similar trends were observed for the cardiovascular and end‐stage renal disease endpoints. Effects of aliskiren compared to placebo on safety outcomes (hyperkalaemia and hospitalization for acute kidney injury) were independent of NT‐proBNP. In conclusion, baseline NT‐proBNP may be used as a marker to predict the response to aliskiren with regard to cardio‐renal outcomes when added to standard therapy with RAAS inhibition.

show abstract

“…An important study looking into the effect of statins in ischemic heart failure was the analysis of the CORONA study by Cleland et al [30]. The authors hypothesized that despite a lack of a protective effect of statins in the general heart failure population, an inverse association exists between the effect of rosuvastatin and NT-proBNP level.…”

Section: Discussionmentioning

confidence: 99%

Efekty leczenia atorwastatyną chorych w średnim wieku z zaawansowaną kardiomiopatią rozstrzeniową — prospektywne randomizowane badanie jednoośrodkowe

2017

View full text Add to dashboard Cite

Plasma Concentration of Amino-Terminal Pro-Brain Natriuretic Peptide in Chronic Heart Failure: Prediction of Cardiovascular Events and Interaction With the Effects of Rosuvastatin

Abstract: Patients with heart failure due to ischemic heart disease who have NT-proBNP values <103 pmol/l (868 pg/ml) may benefit from rosuvastatin.

Cited by 198 publications

References 26 publications

NT-ProBNP and Troponin T and Risk of Rapid Kidney Function Decline and Incident CKD in Elderly Adults

NT-ProBNP and Troponin T and Risk of Rapid Kidney Function Decline and Incident CKD in Elderly Adults

N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) predicts the cardio‐renal response to aliskiren in patients with type 2 diabetes at high renal and cardiovascular risk

Efekty leczenia atorwastatyną chorych w średnim wieku z zaawansowaną kardiomiopatią rozstrzeniową — prospektywne randomizowane badanie jednoośrodkowe

Contact Info

Product

Resources

About