Prognostic and diagnostic significance of mid-regional pro-atrial natriuretic peptide in acute exacerbation of chronic obstructive pulmonary disease and acute heart failure: data from the ACE 2 Study. (3rd October 2018)

• Record Type: Journal Article
• Authors: Pervez, Mohammad Osman; Winther, Jacob A.; Brynildsen, Jon; Strand, Heidi; Christensen, Geir; Høiseth, Arne Didrik; Myhre, Peder L.; Røysland, Ragnhild; Lyngbakken, Magnus Nakrem; Omland, Torbjørn; Røsjø, Helge
• Is Part Of: Biomarkers. Volume 23:Number 7(2018)
• Page Start: 654
• Page End: 663
• Publication Date: 2018-10-03
• Subjects: MR-proANP -- NT-proBNP -- biomarker -- COPD -- heart failure -- prognosis; Biochemical markers -- Periodicals; 610.28
• DOI: 10.1080/1354750X.2018.1474258
• Languages: English
• ISSNs: 1354-750X

Abstract

Abstract: Purpose: To compare the diagnostic and prognostic value of mid-regional pro-ANP (MR-proANP) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in patients with acute dyspnea. Methods: MR-proANP and NT-proBNP were measured with commercial immunoassays at hospital admission ( n = 313), on day 2 ( n = 234), and before discharge ( n = 91) and compared for diagnosing acute heart failure (HF; n = 143) and to predict mortality among patients with acute HF and acute exacerbation of chronic obstructive pulmonary disease (AECOPD; n = 84) separately. Results: The correlation coefficient between MR-proANP and NT-proBNP was 0.89 ( p < 0.001) and the receiver-operating area under the curve (AUC) was 0.85 (95% CI 0.81–0.89) for MR-proANP and 0.86 (0.82–0.90) for NT-proBNP to diagnose acute HF. During a median follow-up of 816 days, mortality rates were 46% in acute HF patients and 42% in AECOPD patients. After adjustment for other risk variables by multivariate Cox regression analysis, MR-proANP and NT-proBNP concentrations were associated with mortality in patients with acute HF, but only MR-proANP were associated with mortality among patients with AECOPD: hazard ratio (ln MR-proANP) 1.98 (95% CI 1.17–3.34). Conclusion: MR-proANP and NT-proBNP concentrations provide similar diagnostic and prognostic information in patients with acute HF. In contrast to NT-proBNP, MR-proANP measurements also provided independent prognostic information in AECOPD patients.