Clinical InvestigationComparative Evaluation of B-Type Natriuretic Peptide, Mid-Regional Pro-A-type Natriuretic Peptide, Mid-Regional Pro-Adrenomedullin, and Copeptin to Predict 1-Year Mortality in Patients With Acute Destabilized Heart Failure
Section snippets
Methods
The present evaluation is a post hoc analysis of a previously described study cohort.12, 13 In brief, 251 consecutive patients consulting the emergency department of the St. John of God Hospital (Linz, Austria) with dyspnea as a chief compliant were prospectively studied to compare head to head the diagnostic accuracies of BNP and NT-proBNP for acute destabilized heart failure in an emergency setting,12 and to demonstrate the capability of both analytes as prognostic markers in these patients.13
Results
Of the 137 patients with acute destabilized heart failure, 41 died and 96 survived within 365 days from the time they were enrolled. The median survival of the patients who died during follow-up was 108 days (range 3–342 days). The baseline patient characteristics for the survivors and nonsurvivors are shown in Table 1. The results of correlation analyses for the main study parameters are given in Table 2.
In distinguishing between patients who died (n = 41) and patients who survived (n = 96),
Discussion
The main finding of the present post hoc analysis is that increased concentrations of BNP, MR-proANP, MR-proADM, and Copeptin determined in plasma samples drawn from patients with acute destabilized heart failure at their initial presentation indicate an increased risk of future mortality. High plasma concentrations of BNP, MR-proANP, MR-proADM, and Copeptin predicted 1-year all-cause mortality independently of other confounders including advanced age, low systolic blood pressure, renal
References (26)
- et al.
Natriuretic peptides BNP and NT-pro-BNP: established laboratory markers in clinical practice or just perspectives?
Clin Chim Acta
(2004) - et al.
B-type natriuretic peptide and amino terminal proBNP predict one-year mortality in short of breath patients independently of the baseline diagnosis of acute destabilized heart failure
Clin Chim Acta
(2006) - et al.
Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: prognostic utility and prediction of benefit from carvedilol in chronic ischemic left ventricular dysfunction. Australia-New Zealand Heart Failure Group
J Am Coll Cardiol
(2001) - et al.
Prognostic importance of atrial natriuretic peptide in patients with chronic heart failure
J Am Coll Cardiol
(1989) - et al.
Prognostic value of neurohumoral activation in patients with an acute myocardial infarction: effect of captopril
J Am Coll Cardiol
(1994) - et al.
Treatment of heart failure guided by plasma aminoterminal brain natriuretic peptide (N-BNP) concentrations
Lancet
(2000) - et al.
Clinical applications of B-type natriuretic peptide (BNP) testing
Eur Heart J
(2003) - et al.
Predicting mortality among patients hospitalized for heart failure: derivation and validation of a clinical model
JAMA
(2003) Cardiac hormones as diagnostic tools in heart failure
Endocr Rev
(2003)- et al.
How well does B-type natriuretic peptide predict death and cardiac events in patients with heart failure: systematic review
BMJ
(2005)
Hormones and hemodynamics in heart failure
N Engl J Med
Immunoluminometric assay for the midregion of pro-atrial natriuretic peptide in human plasma
Clin Chem
Adrenomedullin in heart failure
Hypertens Res
Cited by (205)
Natriuretic peptide testing strategies in heart failure: A 2023 update
2024, Advances in Clinical ChemistryExercise dynamics of cardiac biomarkers and hemoconcentration in patients with chronic systolic heart failure
2020, Journal of Cardiac FailureGlutamate infusion associated with reduced rises of p-Copeptin after coronary surgery: Substudy of GLUTAMICS II
2023, Acta Anaesthesiologica ScandinavicaHeart Failure: Is There an Ideal Biomarker?
2023, Reviews in Cardiovascular Medicine
J.S., N.G.M., and A.G. are employed by B.R.A.M.S. AG, Hennigsdorf, Germany.