Direct Comparison of B-Type Natriuretic Peptide (BNP) and Amino-Terminal proBNP in a Large Population of Patients with Chronic and Symptomatic Heart Failure: The Valsartan Heart Failure (Val-HeFT) Data

Abstract

on behalf of the Val-HeFT InvestigatorsBackground: The B-type or brain natriuretic peptides (BNP) and the amino-terminal probrain natriuretic peptide (NT-proBNP) are good markers of prognosis and diagnosis in chronic heart failure (HF). It is unclear, however, whether differences in their biological characteristics modify their clinical correlates and prognostic performance in HF. This work aimed to provide a direct comparison of the prognostic value of BNP and NTproBNP in patients with chronic and stable HF. Methods: We measured BNP and NT-proBNP at baseline in 3916 patients enrolled in the Valsartan Heart Failure Trial. To identify the variables associated with both peptides, we conducted simple and multivariable linear regression analyses. We used Cox multivariable regression models to evaluate the independent prognostic value for all-cause mortality, mortality and morbidity, and hospitalization for HF. Prognostic performance was assessed by pairwise comparisons of the area under the curve of receiver-operator characteristic curves.

The prognostic value of brain natriuretic peptide in patients with heart failure and left ventricular ejection fraction higher than 60%: a sub‐analysis of the J‐MELODIC study

“…BNP is secreted primarily by cardiac myocytes in response to increase in LV wall stress, resulting in myocyte stretch, and the BNP level shows good correlation with LV end‐diastolic pressure. BNP levels are associated with HF severity across the spectrum of HF stages 9, 10, 11. In the current study, the BNP levels showed a significantly independent predictive value for poor prognosis in patients with HFrEF, HFpEF, and HFrlEF.…”

Role of B‐Type Natriuretic Peptide and N‐Terminal Prohormone BNP as Predictors of Cardiovascular Morbidity and Mortality in Patients With a Recent Coronary Event and Type 2 Diabetes Mellitus

“…Neither biomarker predicted MI. In the Valsartan Heart Failure Trial (Val‐Heft), NT‐proBNP proved superior to BNP in predicting a composite of morbidity and mortality and HF hospitalization in chronic HF patients; however, the incremental discriminatory value of NT‐proBNP versus BNP was small 30. In our study of ACS patients with type 2 diabetes mellitus, both natriuretic peptides had comparable predictive strength in all outcomes studied (death, cardiovascular death, MI, HF, and stroke), albeit NRI and Integrated Discrimination Index values increased slightly more with BNP across all outcomes.…”

Personalized Medicine in Cardiology: State, Problems and Prospects

“…У пациентов с хронической СН BNP может пред-сказать будущие сердечные события и госпитализации [29][30][31]. Результаты исследования Val-HeFT, описанные Masson et al [29], показали, что BNP и NT-proBNP являют-ся самыми сильными предикторами смертности и госпи-тализации по поводу СН.…”

“…Результаты исследования Val-HeFT, описанные Masson et al [29], показали, что BNP и NT-proBNP являют-ся самыми сильными предикторами смертности и госпи-тализации по поводу СН. Увеличение уровня BNP на 50 нг/мл от исходного уровня имело высокий риск по сравнению с объединенным анализом Doust et al, что продемонстрировало увеличение смертности на 35% с увеличением на 100 пг/мл от исходного уровня [30].…”