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N-terminal pro B-type natriuretic peptide as prognostic marker for mortality in coronary patients without clinically manifest heart failure

  • CARDIOVASCULAR DISEASE
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Abstract

Brain natriuretic peptide (BNP) and its inactive N-terminal fragment (NT-proBNP) are strong prognostic markers in patients with manifest heart failure and acute coronary syndromes. We aimed to establish the association between NT-proBNP and all-cause mortality in patients with stable chronic coronary heart disease. Three-hundred-eighty-five patients, 6–24 months after acute coronary syndrome or coronary revascularisation, but without history or symptoms of chronic heart failure, were included into the cohort study. The NT-proBNP was measured at baseline and all-cause mortality was ascertained after more than 6 years of follow-up. Patients with NT-proBNP above 862 pmol/l (i.e. in top quintile) showed significantly higher mortality rates, than patients with lower NT-proBNP; the adjusted odds ratio (and 95% confidence intervals) for all-cause death was in patients with NT-proBNP >862 pmol/l 3.26 (1.40–7.62). In conclusion, the asymptomatic elevation of NT-proBNP provides prognostic information also in stable coronary patients not yet manifesting any symptoms of heart failure.

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Abbreviations

ACS:

Acute coronary syndrome

BNP:

Brain natriuretic peptide

CHD:

Coronary heart disease

CHF:

Congestive heart failure

GLU:

Glucose

HDL:

High-density lipoprotein cholesterol

NT-proBNP:

N-terminal fragment of brain natriuretic peptide

NYHA:

New York Heart Association classification

RF:

Risk factor

TCHOL:

Total cholesterol

TG:

Triglycerides

tHcy:

Total homocysteine

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Acknowledgments

The present study was funded by Internal Grant Agency of Czech Ministry of Health (grant no. 9333-3) and by Ministry of Education (grant no. 0021620819). We also used several data from EUROASPIRE II survey, carried out under auspices of European Society of Cardiology. We would to acknowledge the cooperation of investigators who participated on the EUROASPIRE II survey.

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Authors and Affiliations

  1. Second Department of Internal Medicine, Medical Faculty and University Hospital, Charles University, 13 E. Beneše St., 32000, Plzeň (Pilsen), Czech Republic

    Otto Mayer Jr. & Jaroslav Šimon

  2. Department of Preventive Cardiology, Institute of Clinical and Experimental Medicine, Praha (Prague), Czech Republic

    Markéta Plášková & Renata Cífková

  3. Institute of Clinical Biochemistry, University Hospital, Plzeň (Pilsen), Czech Republic

    Ladislav Trefil

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  1. Otto Mayer Jr.
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  2. Jaroslav Šimon
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Correspondence to Otto Mayer Jr..

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Mayer, O., Šimon, J., Plášková, M. et al. N-terminal pro B-type natriuretic peptide as prognostic marker for mortality in coronary patients without clinically manifest heart failure. Eur J Epidemiol 24, 363–368 (2009). https://doi.org/10.1007/s10654-009-9339-6

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  • DOI: https://doi.org/10.1007/s10654-009-9339-6

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