Heart failure & cardiomyopathies

Differential Associations of A-/B-Type Natriuretic Peptides With Cardiac Structure, Function, and Prognosis in Heart Failure

JACC Heart FailPublished Prospective cohort study

Authors' conclusion

MR-proANP was not inappropriately low relative to concurrent BNP/NT-proBNP values. Proportional increments in MR-proANP were more pronounced than for B-peptides for given decrements in cardiac structure/function. MR-proANP offered greater independent predictive power overall.

Study context

Population
Patients with compensated heart failure (HF)
Participants
1,278 patients
Exposure
Midregional pro-atrial natriuretic peptide (MR-proANP) vs BNP vs NT-proBNP
Outcome
Composite of:
  • HF hospitalization
  • All-cause mortality
Methodological detailsmulticentre
  • Multicentre

Main finding

As reported in the abstract

Single-biomarker models: MR-proANP(log10) associated with the highest hazard for each outcome
4 to 6 times
Multimarker models: independent associations for the primary outcome with MR-proANP and NT-proBNP
P < 0.05
Discrimination for the primary outcome: MR-proANP superior to BNP
P < 0.05

Observational data: associations, not effects.

Secondary outcomes

Plasma concentrations

Cardiac structure/function · baseline and serially

OR (95% CI)
MR-proANPBeneficial LV reverse remodeling0.35 (0.18–0.70)
Cardiac structure/function — MR-proANP increments steeper associations with shifts in LV size, diastolic indexes and LVEF than BNP/NT-proBNP
P < 0.05

Plasma concentrations

No subpopulation with inappropriately low MR-proANP (relative to BNP/NT-proBNP)

HF hospitalization, CV admission, all-cause mortality (multimarker models)

HF hospitalization and CV admission: independent association with MR-proANP only
P < 0.05
All-cause mortality: independent association with NT-proBNP only
P < 0.05
Discrimination for HF hospitalization: MR-proANP superior to BNP/NT-proBNP
P < 0.05

Original publication

Differential Associations of A-/B-Type Natriuretic Peptides With Cardiac Structure, Function, and Prognosis in Heart Failure. JACC Heart Fail. Published 25 October 2023. doi:10.1016/j.jchf.2023.09.011

Composed by AI from the published abstract and checked against it. How Briefs are made →

Get them every week

New studies on this topic in My Week and in your Monday e-mail.

We e-mail you a sign-in link and a code. No password, no spam.