TY - JOUR
T1 - Usefulness of Serial N-Terminal Pro B-Type Natriuretic Peptide Measurements for Determining Prognosis in Patients With Pulmonary Arterial Hypertension
AU - Mauritz, GJ
AU - Rizopoulos, Dimitris
AU - Groepenhoff, H
AU - Tiede, H
AU - Felix, Janine
AU - Eilers, Paul
AU - Bosboom, J
AU - Postmus, PE
AU - Westerhof, N
AU - Vonk-Noordegraaf, A
PY - 2011
Y1 - 2011
N2 - Previous studies have shown the prognostic benefit of N-terminal pro- brain natriuretic peptide (NT-pro-BNP) in pulmonary arterial hypertension (PAH) at time of diagnosis. However, there are only limited data on the clinical utility of serial measurements of the inactive peptide NT-pro-BNP in PAH. This study examined the value of serial NT-pro-BNP measurements in predicting prognosis PAH. We retrospectively analyzed all available NT-pro-BNP plasma samples in 198 patients who were diagnosed with World Health Organization group I PAH from January 2002 through January 2009. At time of diagnosis median NT-pro-BNP levels were significantly different between survivors (610 pg/ml, range 6 to 8,714) and nonsurvivors (2,609 pg/ml, range 28 to 9,828, p <0.001). In addition, NT-pro-BNP was significantly associated (p <0.001) with other parameters of disease severity (6-minute walking distance, functional class). Receiver operating curve analysis identified >= 1,256 pg/ml as the optimal NT-pro-BNP cutoff for predicting mortality at time of diagnosis. Serial measurements allowed calculation of baseline NT-pro-BNP (i.e., intercept obtained by back-extrapolation of concentration-time graph), providing a better discrimination between survivors and nonsurvivors than NT-pro-BNP at time of diagnosis alone (p = 0.010). Furthermore, a decrease of NT-pro-BNP of >15%/year was associated with survival. In conclusion, a serum NT-pro-BNP level >= 1,256 pg/ml at time of diagnosis identifies poor outcome in patients with PAH. In addition, a decrease in NT-pro-BNP of >15%/year is associated with survival in PAH. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:1645-1650)
AB - Previous studies have shown the prognostic benefit of N-terminal pro- brain natriuretic peptide (NT-pro-BNP) in pulmonary arterial hypertension (PAH) at time of diagnosis. However, there are only limited data on the clinical utility of serial measurements of the inactive peptide NT-pro-BNP in PAH. This study examined the value of serial NT-pro-BNP measurements in predicting prognosis PAH. We retrospectively analyzed all available NT-pro-BNP plasma samples in 198 patients who were diagnosed with World Health Organization group I PAH from January 2002 through January 2009. At time of diagnosis median NT-pro-BNP levels were significantly different between survivors (610 pg/ml, range 6 to 8,714) and nonsurvivors (2,609 pg/ml, range 28 to 9,828, p <0.001). In addition, NT-pro-BNP was significantly associated (p <0.001) with other parameters of disease severity (6-minute walking distance, functional class). Receiver operating curve analysis identified >= 1,256 pg/ml as the optimal NT-pro-BNP cutoff for predicting mortality at time of diagnosis. Serial measurements allowed calculation of baseline NT-pro-BNP (i.e., intercept obtained by back-extrapolation of concentration-time graph), providing a better discrimination between survivors and nonsurvivors than NT-pro-BNP at time of diagnosis alone (p = 0.010). Furthermore, a decrease of NT-pro-BNP of >15%/year was associated with survival. In conclusion, a serum NT-pro-BNP level >= 1,256 pg/ml at time of diagnosis identifies poor outcome in patients with PAH. In addition, a decrease in NT-pro-BNP of >15%/year is associated with survival in PAH. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:1645-1650)
U2 - 10.1016/j.amjcard.2011.07.025
DO - 10.1016/j.amjcard.2011.07.025
M3 - Article
C2 - 21890089
SN - 0002-9149
VL - 108
SP - 1645
EP - 1650
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 11
ER -