Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide

Biomarkers for mortality in a large community-based cohort free of heart failure

Paul McKie, Richard J. Rodeheffer, Alessandro Cataliotti, Fernando L. Martin, Lynn H. Urban, Douglas W. Mahoney, Steven J. Jacobsen, Margaret May Redfield, John C Jr. Burnett

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

Recent studies report that, in the absence of heart failure and renal failure, plasma B-type natriuretic peptide (BNP) has prognostic value for mortality. We sought to confirm and extend these previous studies to assess BNP, measured by 3 distinct assays, as a biomarker for mortality in a strategy to enhance efforts at primary prevention and to better understand the clinical phenotype of such subjects at risk. We used a community-based cohort of 2042 subjects from Olmsted County, Minn, and individuals with heart or renal failure were excluded. BNP was assessed using 3 assays including Biosite and Shionogi for mature, biologically active BNP and the Roche assay for apparently nonbiologically active amino-terminal pro-BNP (NT-proBNP). Thorough echocardiographic and clinical data were recorded for all of the participants. Median follow-up for mortality was 5.6 years. BNP by all 3 of the assays was predictive of mortality. NT-proBNP and Biosite assays remained significant even after adjustment for traditional clinical risk factors and echocardiographic abnormalities including left ventricular hypertrophy and diastolic dysfunction. Echocardiography documented widespread structural changes in those with increasing BNP levels yet below levels observed in heart failure. We report in a large, well-characterized community-based cohort, free of heart failure, the first study to compare 3 distinct BNP assays as biomarkers for mortality in the same cohort. Our findings confirm the potential use of NT-proBNP and BNP biomarkers for future events and underscore that these peptides may also serve as biomarkers for underlying cardiac remodeling secondary to diverse cardiovascular disease entities.

Original languageEnglish (US)
Pages (from-to)874-880
Number of pages7
JournalHypertension
Volume47
Issue number5
DOIs
StatePublished - May 2006

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Brain Natriuretic Peptide
Heart Failure
Biomarkers
Mortality
Renal Insufficiency
peptide B
Left Ventricular Hypertrophy
Primary Prevention
Echocardiography
Cardiovascular Diseases
Phenotype
Peptides

Keywords

  • Hypertrophy
  • Natriuretic peptide

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide : Biomarkers for mortality in a large community-based cohort free of heart failure. / McKie, Paul; Rodeheffer, Richard J.; Cataliotti, Alessandro; Martin, Fernando L.; Urban, Lynn H.; Mahoney, Douglas W.; Jacobsen, Steven J.; Redfield, Margaret May; Burnett, John C Jr.

In: Hypertension, Vol. 47, No. 5, 05.2006, p. 874-880.

Research output: Contribution to journalArticle

McKie, Paul ; Rodeheffer, Richard J. ; Cataliotti, Alessandro ; Martin, Fernando L. ; Urban, Lynn H. ; Mahoney, Douglas W. ; Jacobsen, Steven J. ; Redfield, Margaret May ; Burnett, John C Jr. / Amino-terminal pro-B-type natriuretic peptide and B-type natriuretic peptide : Biomarkers for mortality in a large community-based cohort free of heart failure. In: Hypertension. 2006 ; Vol. 47, No. 5. pp. 874-880.
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AU - Rodeheffer, Richard J.

AU - Cataliotti, Alessandro

AU - Martin, Fernando L.

AU - Urban, Lynn H.

AU - Mahoney, Douglas W.

AU - Jacobsen, Steven J.

AU - Redfield, Margaret May

AU - Burnett, John C Jr.

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AB - Recent studies report that, in the absence of heart failure and renal failure, plasma B-type natriuretic peptide (BNP) has prognostic value for mortality. We sought to confirm and extend these previous studies to assess BNP, measured by 3 distinct assays, as a biomarker for mortality in a strategy to enhance efforts at primary prevention and to better understand the clinical phenotype of such subjects at risk. We used a community-based cohort of 2042 subjects from Olmsted County, Minn, and individuals with heart or renal failure were excluded. BNP was assessed using 3 assays including Biosite and Shionogi for mature, biologically active BNP and the Roche assay for apparently nonbiologically active amino-terminal pro-BNP (NT-proBNP). Thorough echocardiographic and clinical data were recorded for all of the participants. Median follow-up for mortality was 5.6 years. BNP by all 3 of the assays was predictive of mortality. NT-proBNP and Biosite assays remained significant even after adjustment for traditional clinical risk factors and echocardiographic abnormalities including left ventricular hypertrophy and diastolic dysfunction. Echocardiography documented widespread structural changes in those with increasing BNP levels yet below levels observed in heart failure. We report in a large, well-characterized community-based cohort, free of heart failure, the first study to compare 3 distinct BNP assays as biomarkers for mortality in the same cohort. Our findings confirm the potential use of NT-proBNP and BNP biomarkers for future events and underscore that these peptides may also serve as biomarkers for underlying cardiac remodeling secondary to diverse cardiovascular disease entities.

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