CLINICAL RESEARCH: CHRONIC CORONARY ARTERY DISEASE
Comparison of B-Type Natriuretic Peptides for Assessment of Cardiac Function and Prognosis in Stable Ischemic Heart Disease
Mark Richards, MD*,*,
M. Gary Nicholls, MD*,
Eric A. Espiner, MD*,
John G. Lainchbury, MD*,
Richard W. Troughton, MD*,
John Elliott, MD*,
Christopher M. Frampton, PhD*,
Ian G. Crozier, MD*,
Timothy G. Yandle, PhD*,
Robert Doughty, MD , ,
Stephen MacMahon, PhD, ,
Norman Sharpe, MD, for the Christchurch Cardioendocrine Research Group the Australia-New Zealand Heart Failure Group
* Christchurch Cardioendocrine Research Group, Christchurch Hospital, Christchurch, New Zealand
Australia-New Zealand Heart Failure Group
Department of Medicine, University of Auckland, Auckland, New Zealand
Institute for International Health, Newtown, Sydney, New South Wales, Australia
Manuscript received January 19, 2005;
revised manuscript received April 28, 2005,
accepted June 13, 2005.
* Reprint requests and correspondence: Dr. A. Mark Richards, Department of Medicine, Christchurch Hospital, Riccarton Avenue, PO Box 4345, Christchurch, New Zealand (Email: mark.richards{at}cdhb.govt.nz).
OBJECTIVES: The aim of this work was to test B-type natriuretic peptides for assessment of function and prognosis in stable ischemic heart disease (IHD) and to compare brain natriuretic peptide (BNP) with amino terminal pro-brain natriuretic peptide (NTproBNP), including the relative effects of age and renal function on test performance.
BACKGROUND: Brain natriuretic peptide and NTproBNP are emerging diagnostic and prognostic markers in heart failure and acute coronary syndromes. Their performance in assessing function and prognosis in stable IHD is unknown. Whether one marker is superior and the relative effects of age and renal function on test performance are uncertain.
METHODS: In 1,049 patients with stable IHD, left ventricular ejection fraction (LVEF) was measured by radionuclide scanning and creatinine clearance estimated by the Cockroft-Gault equation. Age, gender, and body mass index were recorded. Twelve-month all-cause mortality or admission with heart failure was prospectively recorded; BNP and NTproBNP were measured by radioimmunoassay.
RESULTS: Brain natriuretic peptide and NTproBNP correlated closely (r = 0.90, p < 0.001) and had similar relationships to LVEF (r = –0.50 and –0.46, respectively, both p < 0.001), age (0.44 and 0.47, both p < 0.001), and creatinine clearance (–0.51 and –0.51, both p < 0.001). Areas under receiver-operating characteristic curves for detection of LVEF <30% were similar (0.83 and 0.80, both p < 0.001) with strong negative predictive values for both (95% and 94%). Both markers independently predicted the clinical end point with closely overlapping event-free survival curves.
CONCLUSIONS: In stable IHD, BNP and NTproBNP display strong and near-identical test performance in ruling out severely reduced LVEF and in prediction of all-cause mortality or heart failure despite significant effects of age, gender, and renal function on levels of both markers.
|
Abbreviations and Acronyms
| | ANZ = Australia-New Zealand | | AUC = area under the curve | | BMI = body mass index | | BNP = brain natriuretic peptide | | IHD = ischemic heart disease | | LVEF = left ventricular ejection fraction | | NTproBNP = amino terminal pro-brain natriuretic peptide | | NYHA = New York Heart Association | | PMI = post-myocardial infarction | | ROC = receiver-operating characteristic |
|
This article has been cited by other articles:
|
|
|
|
 
G. A. Lurati Buse, M. T. Koller, C. Burkhart, M. D. Seeberger, and M. Filipovic
The Predictive Value of Preoperative Natriuretic Peptide Concentrations in Adults Undergoing Surgery: A Systematic Review and Meta-Analysis
Anesth. Analg.,
May 1, 2011;
112(5):
1019 - 1033.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
I. A. Paraskevaidis, E. Tsougos, C. Varounis, N. Dagres, D. Karatzas, J. Parissis, and D. T. Kremastinos
Exercise-induced changes of B-type natriuretic peptide uncover the unknown coronary artery disease in patients with chest pain and normal left ventricular systolic function
European Journal of Cardiovascular Prevention & Rehabilitation,
February 1, 2011;
18(1):
72 - 78.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. G. Jungbauer, S. Buchner, C. Birner, M. Resch, N. Heinicke, K. Debl, M. Buesing, D. Biermeier, G. Schmitz, G. Riegger, et al.
N-terminal pro-brain natriuretic peptide from fresh urine for the biochemical detection of heart failure and left ventricular dysfunction
Eur J Heart Fail,
April 1, 2010;
12(4):
331 - 337.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. C. Palmer, T. G. Yandle, M. G. Nicholls, C. M. Frampton, and A. M. Richards
Regional clearance of amino-terminal pro-brain natriuretic peptide from human plasma
Eur J Heart Fail,
September 1, 2009;
11(9):
832 - 839.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
R. R.J. van Kimmenade, J. L. Januzzi Jr, J. A. Bakker, A. J. Houben, R. Rennenberg, A. A. Kroon, H. J.G.M. Crijns, M. P. van Dieijen-Visser, P. W. de Leeuw, and Y. M. Pinto
Renal Clearance of B-Type Natriuretic Peptide and Amino Terminal Pro-B-Type Natriuretic Peptide: A Mechanistic Study in Hypertensive Subjects
J. Am. Coll. Cardiol.,
March 10, 2009;
53(10):
884 - 890.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. C. Palmer and A. M. Richards
Does Renal Clearance Differ Between the B-Type Natriuretic Peptides (BNP Versus NT-proBNP)?
J. Am. Coll. Cardiol.,
March 10, 2009;
53(10):
891 - 892.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Mueller, B. Dieplinger, W. Poelz, G. Endler, O. F. Wagner, and M. Haltmayer
Amino-Terminal Pro-B-Type Natriuretic Peptide as Predictor of Mortality in Patients with Symptomatic Peripheral Arterial Disease: 5-Year Follow-Up Data from the Linz Peripheral Arterial Disease Study
Clin. Chem.,
January 1, 2009;
55(1):
68 - 77.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Vila, M. Resl, D. Stelzeneder, J. Struck, C. Maier, M. Riedl, M. Hulsmann, R. Pacher, A. Luger, and M. Clodi
Plasma NT-proBNP increases in response to LPS administration in healthy men
J Appl Physiol,
December 1, 2008;
105(6):
1741 - 1745.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A L Baggish, D M Lloyd-Jones, J Blatt, A M Richards, J Lainchbury, M O'Donoghue, R Sakhuja, A A Chen, and J L Januzzi
A clinical and biochemical score for mortality prediction in patients with acute dyspnoea: derivation, validation and incorporation into a bedside programme
Heart,
August 1, 2008;
94(8):
1032 - 1037.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. B. Daniels and A. S. Maisel
Natriuretic Peptides
J. Am. Coll. Cardiol.,
December 18, 2007;
50(25):
2357 - 2368.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. G. Olsson, K. Swedberg, J. G.F. Cleland, P. A. Spark, M. Komajda, M. Metra, C. Torp-Pedersen, W. J. Remme, A. Scherhag, P. Poole-Wilson, et al.
Prognostic importance of plasma NT-pro BNP in chronic heart failure in patients treated with a {beta}-blocker: Results from the Carvedilol Or Metoprolol European Trial (COMET) trial
Eur J Heart Fail,
August 1, 2007;
9(8):
795 - 801.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W.H. Wilson Tang, G. S. Francis, D. A. Morrow, L. K. Newby, C. P. Cannon, R. L. Jesse, A. B. Storrow, R. H. Christenson, COMMITTEE MEMBERS, R. H. Christenson, et al.
National Academy of Clinical Biochemistry Laboratory Medicine Practice Guidelines: Clinical Utilization of Cardiac Biomarker Testing in Heart Failure
Circulation,
July 31, 2007;
116(5):
e99 - e109.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Mueller
The Use of B-Type Natriuretic Peptides in Coronary Artery Disease: Utile or Futile?
J. Am. Coll. Cardiol.,
July 17, 2007;
50(3):
215 - 216.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Omland, M. S. Sabatine, K. A. Jablonski, M. M. Rice, J. Hsia, R. Wergeland, S. Landaas, J. L. Rouleau, M. J. Domanski, C. Hall, et al.
Prognostic Value of B-Type Natriuretic Peptides in Patients With Stable Coronary Artery Disease: The PEACE Trial
J. Am. Coll. Cardiol.,
July 17, 2007;
50(3):
205 - 214.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. M. Richards
Natriuretic Peptides: Update on Peptide Release, Bioactivity, and Clinical Use
Hypertension,
July 1, 2007;
50(1):
25 - 30.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. J. Mocatta, A. P. Pilbrow, V. A. Cameron, R. Senthilmohan, C. M. Frampton, A. M. Richards, and C. C. Winterbourn
Plasma Concentrations of Myeloperoxidase Predict Mortality After Myocardial Infarction
J. Am. Coll. Cardiol.,
May 22, 2007;
49(20):
1993 - 2000.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. Th. Kremastinos, D. P. Tsiapras, A. G. Kostopoulou, E. S. Hamodraka, A. S. Chaidaroglou, and E. D. Kapsali
NT-proBNP levels and diastolic dysfunction in {beta}-Thalassaemia major patients
Eur J Heart Fail,
May 1, 2007;
9(5):
531 - 536.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Clerico, M. Fontana, L. Zyw, C. Passino, and M. Emdin
Comparison of the Diagnostic Accuracy of Brain Natriuretic Peptide (BNP) and the N-Terminal Part of the Propeptide of BNP Immunoassays in Chronic and Acute Heart Failure: A Systematic Review
Clin. Chem.,
May 1, 2007;
53(5):
813 - 822.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. M. Heublein, B. K. Huntley, G. Boerrigter, A. Cataliotti, S. M. Sandberg, M. M. Redfield, and J. C. Burnett Jr
Immunoreactivity and Guanosine 3',5'-Cyclic Monophosphate Activating Actions of Various Molecular Forms of Human B-Type Natriuretic Peptide
Hypertension,
May 1, 2007;
49(5):
1114 - 1119.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. M. P. Aleman, A. W. van den Belt-Dusebout, M. L. De Bruin, M. B. van 't Veer, M. H. A. Baaijens, J. P. d. Boer, A. A. M. Hart, W. J. Klokman, M. A. Kuenen, G. M. Ouwens, et al.
Late cardiotoxicity after treatment for Hodgkin lymphoma
Blood,
March 1, 2007;
109(5):
1878 - 1886.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
W.H. W. Tang and G. S. Francis
The Year in Heart Failure
J. Am. Coll. Cardiol.,
December 19, 2006;
48(12):
2575 - 2583.
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. Abroug, L. Ouanes-Besbes, N. Nciri, N. Sellami, F. Addad, K. B. Hamda, A. B. Amor, M. F. Najjar, and J. Knani
Association of Left-Heart Dysfunction with Severe Exacerbation of Chronic Obstructive Pulmonary Disease: Diagnostic Performance of Cardiac Biomarkers
Am. J. Respir. Crit. Care Med.,
November 1, 2006;
174(9):
990 - 996.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Masson, R. Latini, I. S. Anand, T. Vago, L. Angelici, S. Barlera, E. D. Missov, A. Clerico, G. Tognoni, J. N. Cohn, et al.
Direct Comparison of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in a Large Population of Patients with Chronic and Symptomatic Heart Failure: The Valsartan Heart Failure (Val-HeFT) Data
Clin. Chem.,
August 1, 2006;
52(8):
1528 - 1538.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Kistorp
Risk Stratification in Secondary Prevention: Advances in Multimarker Profiles, or Back to Basics?
Circulation,
July 18, 2006;
114(3):
184 - 186.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Maisel
The Coming of Age of Natriuretic Peptides: The Emperor Does Have Clothes!
J. Am. Coll. Cardiol.,
January 3, 2006;
47(1):
61 - 64.
[Full Text]
[PDF]
|
|
|
|
