Plasma brain natriuretic peptide concentrations predict survival after acute myocardial infarction

Second Department of Internal Medicine, Iwate Medical University, Japan.

OBJECTIVES: This study sought to examine whether plasma brain natriuretic peptide levels can predict prognosis after myocardial infarction. BACKGROUND: It has been suggested that concentrations of plasma brain natriuretic peptide reflect left ventricular function. Although the prognosis after myocardial infarction depends on residual left ventricular function, it is not known whether plasma levels of brain natriuretic peptide after the onset of myocardial infarction can be used to predict long-term outcome. METHODS: Plasma brain natriuretic peptide and atrial natriuretic peptide levels as well as invasive hemodynamic variables were measured in 70 patients with acute myocardial infarction (53 men, 17 women; mean age 65 years). Measurements were obtained on admission (mean 6 h after onset) and on day 2 after onset. Mean follow-up period was 18 months. RESULTS: Plasma brain natriuretic peptide levels measured on admission and day 2 correlated significantly with hemodynamic variables, which are influenced by left ventricular function. However, plasma atrial natriuretic peptide levels correlated with none of the hemodynamic variables measured on admission; and of those measured on day 2, plasma atrial natriuretic peptide levels correlated only with left atrial filling pressure. During the follow-up period (mean 18 +/- 7 months), 11 patients died of cardiac causes. By Kaplan-Meier analysis, it was found that patients with plasma brain natriuretic peptide levels higher than the median level, both on admission and on day 2, had significantly higher mortality rates than those with the submedian level (on admission, p < 0.01; on day 2, p < 0.05). However, only the plasma atrial natriuretic peptide level obtained immediately after admission was significantly related to survival (p < 0.01). By Cox proportional hazards model analysis of the noninvasive variables, it was found that plasma brain natriuretic peptide concentration was more closely related to survival after myocardial infarction (p = 0.0001). CONCLUSIONS: Increased plasma brain natriuretic peptide concentrations in the early or subacute phase of myocardial infarction are a powerful noninvasive indicator of poor prognosis, possibly reflecting residual left ventricular function after myocardial infarction.

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				M Nakamura, H Endo, M Nasu, N Arakawa, T Segawa, and K Hiramori Value of plasma B type natriuretic peptide measurement for heart disease screening in a Japanese population Heart, February 1, 2002; 87(2): 131 - 135. [Abstract] [Full Text] [PDF]

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				J G Crilley and M Farrer Left ventricular remodelling and brain natriuretic peptide after first myocardial infarction Heart, December 1, 2001; 86(6): 638 - 642. [Abstract] [Full Text] [PDF]

				J. A. de Lemos, D. A. Morrow, J. H. Bentley, T. Omland, M. S. Sabatine, C. H. McCabe, C. Hall, C. P. Cannon, and E. Braunwald The Prognostic Value of B-Type Natriuretic Peptide in Patients with Acute Coronary Syndromes N. Engl. J. Med., October 4, 2001; 345(14): 1014 - 1021. [Abstract] [Full Text] [PDF]

				A. M. Richards, R. Doughty, M. G. Nicholls, S. MacMahon, N. Sharpe, J. Murphy, E. A. Espiner, C. Frampton, T. G. Yandle, and for the Australia-New Zealand Heart Failure Group Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: Prognostic utility and prediction of benefit from carvedilol in chronic ischemic left ventricular dysfunction J. Am. Coll. Cardiol., June 1, 2001; 37(7): 1781 - 1787. [Abstract] [Full Text] [PDF]

				Q. He, D. Wang, X.-P. Yang, O. A. Carretero, and M. C. LaPointe Inducible regulation of human brain natriuretic peptide promoter in transgenic mice Am J Physiol Heart Circ Physiol, January 1, 2001; 280(1): H368 - H376. [Abstract] [Full Text] [PDF]

				B. Frey, R. Pacher, G. Locker, A. Bojic, E. Hartter, W. Woloszczuk, and B. Stanek Prognostic Value of Hemodynamic vs Big Endothelin Measurements During Long-term IV Therapy in Advanced Heart Failure Patients Chest, June 1, 2000; 117(6): 1713 - 1719. [Abstract] [Full Text] [PDF]

				Q. He, G. Wu, and M. C. Lapointe Isoproterenol and cAMP regulation of the human brain natriuretic peptide gene involves Src and Rac Am J Physiol Endocrinol Metab, June 1, 2000; 278(6): E1115 - E1123. [Abstract] [Full Text] [PDF]

				T. Langenickel, I. Pagel, K. Hohnel, R. Dietz, and R. Willenbrock Differential regulation of cardiac ANP and BNP mRNA in different stages of experimental heart failure Am J Physiol Heart Circ Physiol, May 1, 2000; 278(5): H1500 - H1506. [Abstract] [Full Text] [PDF]

				M. T. Rademaker, V. A. Cameron, C. J. Charles, E. A. Espiner, M. G. Nicholls, C. J. Pemberton, and A. M. Richards Neurohormones in an ovine model of compensated postinfarction left ventricular dysfunction Am J Physiol Heart Circ Physiol, March 1, 2000; 278(3): H731 - H740. [Abstract] [Full Text] [PDF]

				Q. He and M. C. LaPointe Interleukin-1{beta} Regulates the Human Brain Natriuretic Peptide Promoter via Ca2+-Dependent Protein Kinase Pathways Hypertension, January 1, 2000; 35(1): 292 - 296. [Abstract] [Full Text] [PDF]

				A. M. Richards, R. Doughty, M. G. Nicholls, S. Macmahon, H. Ikram, N. Sharpe, E. A. Espiner, C. Frampton, and T. G. Yandle Neurohumoral Prediction of Benefit From Carvedilol in Ischemic Left Ventricular Dysfunction Circulation, February 16, 1999; 99(6): 786 - 792. [Abstract] [Full Text] [PDF]

				A M Richards, M G Nicholls, T G Yandle, H Ikram, E A Espiner, J G Turner, R C Buttimore, J G Lainchbury, J M Elliott, C Frampton, et al. Neuroendocrine prediction of left ventricular function and heart failure after acute myocardial infarction Heart, February 1, 1999; 81(2): 114 - 120. [Abstract] [Full Text]

				I. Rubinstein and F. D. Hong Circulating Natriuretic Peptides : A Biologic Marker of Tissue Injury? Chest, January 1, 1999; 115(1): 7 - 8. [Full Text] [PDF]

				Q. He and M. C. LaPointe Interleukin-1ß Regulation of the Human Brain Natriuretic Peptide Promoter Involves Ras-, Rac-, and p38 Kinase–Dependent Pathways in Cardiac Myocytes Hypertension, January 1, 1999; 33(1): 283 - 289. [Abstract] [Full Text] [PDF]

				A. M. Richards, M. G. Nicholls, T. G. Yandle, C. Frampton, E. A. Espiner, J. G. Turner, R. C. Buttimore, J. G. Lainchbury, J. M. Elliott, H. Ikram, et al. Plasma N-Terminal Pro–Brain Natriuretic Peptide and Adrenomedullin : New Neurohormonal Predictors of Left Ventricular Function and Prognosis After Myocardial Infarction Circulation, May 19, 1998; 97(19): 1921 - 1929. [Abstract] [Full Text] [PDF]

				D. R Murdoch, J. Byrne, J. J Morton, T. A McDonagh, S. D Robb, S. Clements, I. Ford, J. J V McMurray, and H. J Dargie Brain natriuretic peptide is stable in whole blood and can be measured using a simple rapid assay: implications for clinical practice Heart, December 1, 1997; 78(6): 594 - 597. [Abstract] [Full Text] [PDF]