Circulating C-Type Natriuretic Peptide and Its Relationship to Cardiovascular Disease in the General Population

S Jeson Sangaralingham, Paul McKie, Tomoko Ichiki, Christopher G. Scott, Denise M. Heublein, Horng Haur Chen, Kent R Bailey, Margaret May Redfield, Richard J. Rodeheffer, John C Jr. Burnett

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

C-type natriuretic peptide (CNP) is an endothelium-derived peptide that is released as a protective mechanism in response cardiovascular injury or disease. However, no studies have investigated circulating CNP, identifying clinical factors that may influence CNP and its relationship to cardiovascular disease in the general population. We studied 1841 randomly selected subjects from Olmsted County, MN (mean age, 63±11 years; 48% men). Plasma CNP was measured by a well-established radioimmunoassay and echocardiography, clinical characterization, and detailed medical record review were performed. We report that CNP circulates at various concentrations (median, 13 pg/mL), was unaffected by sex, was weakly associated by age, and that highest quartile of CNP identified a high-risk phenotype. Subjects with CNP in the highest quartile were associated with increased risk of myocardial infarction (multivariable-adjusted hazard ratio, 1.51; 95% confidence interval, 1.09-2.09; P=0.01) but not heart failure, cerebrovascular accidents, or death during a follow-up of 12 years. Addition of the highest quartile of CNP to clinical variables led to a modest increase in the integrated discrimination improvement for risk of myocardial infarction. In a large community-based cohort, elevated circulating CNP identified a high-risk phenotype that included cardiovascular comorbidities and left ventricular dysfunction, and provided evidence that highest concentrations of CNP potentially has prognostic value in predicting future risk of myocardial infarction. Together, these data from the general population highlight the potential value of CNP and support the need for additional studies to evaluate whether mechanisms regulating CNP could improve outcomes.

Original languageEnglish (US)
Pages (from-to)1187-1194
Number of pages8
JournalHypertension
Volume65
Issue number6
DOIs
StatePublished - Jun 20 2015

Fingerprint

C-Type Natriuretic Peptide
Cardiovascular Diseases
Population
Myocardial Infarction
Phenotype
Left Ventricular Dysfunction
Endothelium
Radioimmunoassay
Medical Records
Echocardiography

Keywords

  • biological markers
  • C-type natriuretic peptide
  • cardiovascular diseases
  • endothelium
  • myocardial infarction

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Circulating C-Type Natriuretic Peptide and Its Relationship to Cardiovascular Disease in the General Population. / Sangaralingham, S Jeson; McKie, Paul; Ichiki, Tomoko; Scott, Christopher G.; Heublein, Denise M.; Chen, Horng Haur; Bailey, Kent R; Redfield, Margaret May; Rodeheffer, Richard J.; Burnett, John C Jr.

In: Hypertension, Vol. 65, No. 6, 20.06.2015, p. 1187-1194.

Research output: Contribution to journalArticle

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