Response of novel biomarkers to BNP infusion in patients with decompensated heart failure: A multimarker paradigm

Wayne L. Miller, Karen A. Hartman, David O. Hodge, Stacy Hartman, Joachim Struck, Nils G. Morgenthaler, Andreas Bergmann, Allan S Jaffe

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Multibiomarker paradigms have been proposed to diagnose, define progression, and to monitor therapy of heart failure (HF) patients. The aim of this study was to evaluate the prognostic and therapy-monitoring potential of four novel biomarkers (copeptin, midregional proatrial natriuretic peptide (MR-proANP), neopterin, and procalcitonin) which have been shown to be elevated in the plasma of patients with HF and reported to have prognostic value. In a prospective study of 40 patients hospitalized for decompensated HF and who received nesiritide infusions as part of their care, blood was drawn before, during, and postinfusion and assayed for the novel biomarkers. B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) which were previously measured and reported in this cohort were also included in the analyses. All biomarkers were elevated at baseline prior to nesiritide infusion, but copeptin, MR-proANP, and NT-proBNP demonstrated significant acute reductions in plasma levels in response to therapy. Copeptin levels were higher in posthospital nonsurvivors and by proportional hazards model were associated with an increased mortality risk (p = 0.04). Procalcitonin and neopterin added no incremental information on response to therapy or risk stratification. In contrast, copeptin and MR-proANP appear to have potential for monitoring acute responses to therapy. Only copeptin and BNP contributed to risk stratification in this cohort of advanced HF patients, but the conjoint use of BNP or NT-proBNP does not appear to impact the prognostic value of copeptin alone. These results are hypothesis generating to stimulate additional investigation.

Original languageEnglish (US)
Pages (from-to)526-535
Number of pages10
JournalJournal of Cardiovascular Translational Research
Volume2
Issue number4
DOIs
StatePublished - Dec 2009

Fingerprint

Brain Natriuretic Peptide
Heart Failure
Biomarkers
Natriuretic Peptides
Neopterin
Calcitonin
Therapeutics
Proportional Hazards Models
copeptins
Prospective Studies
Mortality

Keywords

  • Copeptin
  • Heart Failure
  • MR-proANP
  • Neopterin
  • Novel Biomarkers
  • Procalcitonin

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Genetics
  • Genetics(clinical)
  • Molecular Medicine
  • Pharmaceutical Science

Cite this

Response of novel biomarkers to BNP infusion in patients with decompensated heart failure : A multimarker paradigm. / Miller, Wayne L.; Hartman, Karen A.; Hodge, David O.; Hartman, Stacy; Struck, Joachim; Morgenthaler, Nils G.; Bergmann, Andreas; Jaffe, Allan S.

In: Journal of Cardiovascular Translational Research, Vol. 2, No. 4, 12.2009, p. 526-535.

Research output: Contribution to journalArticle

Miller, Wayne L. ; Hartman, Karen A. ; Hodge, David O. ; Hartman, Stacy ; Struck, Joachim ; Morgenthaler, Nils G. ; Bergmann, Andreas ; Jaffe, Allan S. / Response of novel biomarkers to BNP infusion in patients with decompensated heart failure : A multimarker paradigm. In: Journal of Cardiovascular Translational Research. 2009 ; Vol. 2, No. 4. pp. 526-535.
@article{07dfe6f221bc42509ec2e290f1c5596e,
title = "Response of novel biomarkers to BNP infusion in patients with decompensated heart failure: A multimarker paradigm",
abstract = "Multibiomarker paradigms have been proposed to diagnose, define progression, and to monitor therapy of heart failure (HF) patients. The aim of this study was to evaluate the prognostic and therapy-monitoring potential of four novel biomarkers (copeptin, midregional proatrial natriuretic peptide (MR-proANP), neopterin, and procalcitonin) which have been shown to be elevated in the plasma of patients with HF and reported to have prognostic value. In a prospective study of 40 patients hospitalized for decompensated HF and who received nesiritide infusions as part of their care, blood was drawn before, during, and postinfusion and assayed for the novel biomarkers. B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) which were previously measured and reported in this cohort were also included in the analyses. All biomarkers were elevated at baseline prior to nesiritide infusion, but copeptin, MR-proANP, and NT-proBNP demonstrated significant acute reductions in plasma levels in response to therapy. Copeptin levels were higher in posthospital nonsurvivors and by proportional hazards model were associated with an increased mortality risk (p = 0.04). Procalcitonin and neopterin added no incremental information on response to therapy or risk stratification. In contrast, copeptin and MR-proANP appear to have potential for monitoring acute responses to therapy. Only copeptin and BNP contributed to risk stratification in this cohort of advanced HF patients, but the conjoint use of BNP or NT-proBNP does not appear to impact the prognostic value of copeptin alone. These results are hypothesis generating to stimulate additional investigation.",
keywords = "Copeptin, Heart Failure, MR-proANP, Neopterin, Novel Biomarkers, Procalcitonin",
author = "Miller, {Wayne L.} and Hartman, {Karen A.} and Hodge, {David O.} and Stacy Hartman and Joachim Struck and Morgenthaler, {Nils G.} and Andreas Bergmann and Jaffe, {Allan S}",
year = "2009",
month = "12",
doi = "10.1007/s12265-009-9121-x",
language = "English (US)",
volume = "2",
pages = "526--535",
journal = "Journal of Cardiovascular Translational Research",
issn = "1937-5387",
publisher = "Springer New York",
number = "4",

}

TY - JOUR

T1 - Response of novel biomarkers to BNP infusion in patients with decompensated heart failure

T2 - A multimarker paradigm

AU - Miller, Wayne L.

AU - Hartman, Karen A.

AU - Hodge, David O.

AU - Hartman, Stacy

AU - Struck, Joachim

AU - Morgenthaler, Nils G.

AU - Bergmann, Andreas

AU - Jaffe, Allan S

PY - 2009/12

Y1 - 2009/12

N2 - Multibiomarker paradigms have been proposed to diagnose, define progression, and to monitor therapy of heart failure (HF) patients. The aim of this study was to evaluate the prognostic and therapy-monitoring potential of four novel biomarkers (copeptin, midregional proatrial natriuretic peptide (MR-proANP), neopterin, and procalcitonin) which have been shown to be elevated in the plasma of patients with HF and reported to have prognostic value. In a prospective study of 40 patients hospitalized for decompensated HF and who received nesiritide infusions as part of their care, blood was drawn before, during, and postinfusion and assayed for the novel biomarkers. B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) which were previously measured and reported in this cohort were also included in the analyses. All biomarkers were elevated at baseline prior to nesiritide infusion, but copeptin, MR-proANP, and NT-proBNP demonstrated significant acute reductions in plasma levels in response to therapy. Copeptin levels were higher in posthospital nonsurvivors and by proportional hazards model were associated with an increased mortality risk (p = 0.04). Procalcitonin and neopterin added no incremental information on response to therapy or risk stratification. In contrast, copeptin and MR-proANP appear to have potential for monitoring acute responses to therapy. Only copeptin and BNP contributed to risk stratification in this cohort of advanced HF patients, but the conjoint use of BNP or NT-proBNP does not appear to impact the prognostic value of copeptin alone. These results are hypothesis generating to stimulate additional investigation.

AB - Multibiomarker paradigms have been proposed to diagnose, define progression, and to monitor therapy of heart failure (HF) patients. The aim of this study was to evaluate the prognostic and therapy-monitoring potential of four novel biomarkers (copeptin, midregional proatrial natriuretic peptide (MR-proANP), neopterin, and procalcitonin) which have been shown to be elevated in the plasma of patients with HF and reported to have prognostic value. In a prospective study of 40 patients hospitalized for decompensated HF and who received nesiritide infusions as part of their care, blood was drawn before, during, and postinfusion and assayed for the novel biomarkers. B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-proBNP) which were previously measured and reported in this cohort were also included in the analyses. All biomarkers were elevated at baseline prior to nesiritide infusion, but copeptin, MR-proANP, and NT-proBNP demonstrated significant acute reductions in plasma levels in response to therapy. Copeptin levels were higher in posthospital nonsurvivors and by proportional hazards model were associated with an increased mortality risk (p = 0.04). Procalcitonin and neopterin added no incremental information on response to therapy or risk stratification. In contrast, copeptin and MR-proANP appear to have potential for monitoring acute responses to therapy. Only copeptin and BNP contributed to risk stratification in this cohort of advanced HF patients, but the conjoint use of BNP or NT-proBNP does not appear to impact the prognostic value of copeptin alone. These results are hypothesis generating to stimulate additional investigation.

KW - Copeptin

KW - Heart Failure

KW - MR-proANP

KW - Neopterin

KW - Novel Biomarkers

KW - Procalcitonin

UR - http://www.scopus.com/inward/record.url?scp=75949106628&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=75949106628&partnerID=8YFLogxK

U2 - 10.1007/s12265-009-9121-x

DO - 10.1007/s12265-009-9121-x

M3 - Article

C2 - 20560012

AN - SCOPUS:75949106628

VL - 2

SP - 526

EP - 535

JO - Journal of Cardiovascular Translational Research

JF - Journal of Cardiovascular Translational Research

SN - 1937-5387

IS - 4

ER -