PMID- 17996563
OWN - NLM
STAT- MEDLINE
DCOM- 20071206
LR  - 20220330
IS  - 1558-3597 (Electronic)
IS  - 0735-1097 (Linking)
VI  - 50
IP  - 20
DP  - 2007 Nov 13
TI  - Comparison of midregional pro-atrial natriuretic peptide with N-terminal 
      pro-B-type natriuretic peptide in predicting survival in patients with chronic 
      heart failure.
PG  - 1973-80
AB  - OBJECTIVES: Our aim was assess the prognostic value of midregional pro-atrial 
      natriuretic peptide (MR-proANP) using a new immunoassay in patients with chronic 
      heart failure (HF). BACKGROUND: Assessment of natriuretic peptides represents a 
      useful addition in establishing the diagnosis of chronic HF. Their plasma values 
      are powerful predictors of survival in chronic HF. METHODS: We assessed MR-proANP 
      in 525 chronic HF patients (derivation study: age 61 +/- 12 years, New York Heart 
      Association (NYHA) functional class I/II/III/IV 6%/44%/41%/9%, N-terminal 
      pro-B-type natriuretic peptide (NT-proBNP) 3,637 +/- 6,362 pg/ml) and validated 
      our findings in 249 additional chronic HF patients (age 63 +/- 9 years, NYHA 
      functional class I/II/III/IV 14%/50%/33%/3%, NT-proBNP 1,116 +/- 1,991 pg/ml). 
      RESULTS: The MR-proANP levels (mean 339 +/- 306 pmol/l, range 24.5 to 2,280 
      pmol/l) increased with NYHA functional class (p < 0.0001). During follow-up (>6 
      months in survivors), 171 patients (33%) died. Increasing MR-proANP was a 
      predictor of poor survival (risk ratio 1.35 per increase in standard deviation, 
      95% confidence interval 1.17 to 1.57; p = 0.0061), adjusted for NT-proBNP, age, 
      left ventricular ejection fraction, NYHA functional class, creatinine, and body 
      mass index (BMI). In receiver operating characteristic curve analysis of 12-month 
      survival, the area under the curve for MR-proANP was 0.74 and that of NT-proBNP 
      was 0.75 (p = 0.7). In a validation study, MR-proANP levels above the optimal 
      prognostic cutoff value from the validation cohort remained a significant 
      independent predictor of death. In chronic HF patients in NYHA functional class 
      II to III and all subgroups of BMI and kidney function, MR-proANP added 
      prognostic value to NT-proBNP. In patients with BMI > or =30 kg/m2, MR-proANP had 
      higher prognostic power than NT-proBNP. CONCLUSIONS: Midregional proANP is an 
      independent predictor of mortality in patients with chronic HF. Midregional 
      proANP adds prognostic information to NT-proBNP.
FAU - von Haehling, Stephan
AU  - von Haehling S
AD  - Applied Cachexia Research, Department of Cardiology, Charite Medical School, 
      Berlin, Germany. stephan.von.haehling@web.de
FAU - Jankowska, Ewa A
AU  - Jankowska EA
FAU - Morgenthaler, Nils G
AU  - Morgenthaler NG
FAU - Vassanelli, Corrado
AU  - Vassanelli C
FAU - Zanolla, Luisa
AU  - Zanolla L
FAU - Rozentryt, Piotr
AU  - Rozentryt P
FAU - Filippatos, Gerasimos S
AU  - Filippatos GS
FAU - Doehner, Wolfram
AU  - Doehner W
FAU - Koehler, Friedrich
AU  - Koehler F
FAU - Papassotiriou, Jana
AU  - Papassotiriou J
FAU - Kremastinos, Dimitrios T
AU  - Kremastinos DT
FAU - Banasiak, Waldemar
AU  - Banasiak W
FAU - Struck, Joachim
AU  - Struck J
FAU - Ponikowski, Piotr
AU  - Ponikowski P
FAU - Bergmann, Andreas
AU  - Bergmann A
FAU - Anker, Stefan D
AU  - Anker SD
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Validation Study
DEP - 20071029
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
RN  - 0 (Biomarkers)
RN  - 0 (Peptide Fragments)
RN  - 0 (pro-brain natriuretic peptide (1-76))
RN  - 114471-18-0 (Natriuretic Peptide, Brain)
RN  - 85637-73-6 (Atrial Natriuretic Factor)
SB  - IM
MH  - Aged
MH  - Atrial Natriuretic Factor/*blood
MH  - Biomarkers/blood
MH  - Chronic Disease
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*blood/diagnosis/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Natriuretic Peptide, Brain/*blood
MH  - Peptide Fragments/*blood
MH  - Predictive Value of Tests
MH  - Survival Rate/*trends
EDAT- 2007/11/13 09:00
MHDA- 2007/12/07 09:00
CRDT- 2007/11/13 09:00
PHST- 2006/10/11 00:00 [received]
PHST- 2007/07/12 00:00 [revised]
PHST- 2007/08/14 00:00 [accepted]
PHST- 2007/11/13 09:00 [pubmed]
PHST- 2007/12/07 09:00 [medline]
PHST- 2007/11/13 09:00 [entrez]
AID - S0735-1097(07)02661-7 [pii]
AID - 10.1016/j.jacc.2007.08.012 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2007 Nov 13;50(20):1973-80. doi: 10.1016/j.jacc.2007.08.012. 
      Epub 2007 Oct 29.