• Marie-France Seronde, Etienne Gayat, Damien Logeart, Johan Lassus, Said Laribi, Riadh Boukef, Franck Sibellas, Jean-Marie Launay, Philippe Manivet, Malha Sadoune, Semir Nouira, Alain Cohen Solal, Alexandre Mebazaa, and Great network.
• Department of Cardiology EA3920, University Hospital Jean Minjoz, Besancon, France; UMRS 942 Inserm, 75010 Paris, France.
• Int. J. Cardiol. 2013 Oct 9;168(4):3404-11.

BackgroundWe compared diagnostic and prognostic properties of brain natruiretic peptide (BNP), proBNP, NT-proBNP and MR-pro-atrial natriuretic peptide (ANP) in patients admitted with shortness of breath (SOB).MethodsAll 4 NPs were measured in patients admitted to the emergency unit with SOB (in 2 centers) or acute heart failure (AHF) (1 FINN-AKVA cohort) and in a control population of stable chronic HF. Follow-up was 1 (2 centers) and 5 years (1 FINN-AKVA cohort). Area under the curve (AUC) was used to assess diagnostic properties. AUC, multivariate Cox regression, net reclassification improvement (NRI), and Kaplan-Meier analyses were used to assess mortality.ResultsWe included 710 patients ("Biomarcoeurs" cohort n=336; FINN-AKVA study, n=306; stable chronic HF, n=68). Pro-BNP was almost as powerful as BNP to diagnose AHF (AUC 0.953 vs 0.973 respectively, p=0.003), NT-proBNP also performed well (0.922, p<0.001 vs BNP). MR-proANP performed less well (0.901). AUC over time showed greater MR-proANP values over the first year. At 5 years, MR-proANP had the best prognostic value (AUC 0.668 vs 0.604 for BNP, p=0.042). Kaplan Meier analysis confirmed better survival with MR-proANP≤416.8 pmol/L at 5 years. NRI at 5 years was greater for MR-proANP (0.23, p<0.05) than for proBNP, BNP or NTproBNP (p=NS).ConclusionOur study provides firm evidence that all NPs perform equally well for diagnostic purposes, and that MR-proANP has long term prognostic value in patients with acute heart failure.Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

25 keywords...

hide…