Heart failure & cardiomyopathiesCohort study
Differential Associations of A-/B-Type Natriuretic Peptides With Cardiac Structure, Function, and Prognosis in Heart Failure
- Prospective cohort study
- multicentre
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
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
| Comparison | OR (95% CI) | |
|---|---|---|
| MR-proANP · beneficial LV reverse remodeling | 0.35 (0.18–0.70) | |
| 0.20.5125Odds ratio (log scale) |
- 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
Summarised from the published abstract; every number is checked against it