Effect of anemia on plasma concentrations of NT-proBNP

Willis, Monte S.; Lee, Eunice S.; Grenache, David G.

doi:10.1016/j.cccn.2005.03.009

Cited by 40 publications

(34 citation statements)

References 32 publications

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“…However, decreased concentrations of Hb are sufficient to produce serum concentrations of NT-proBNP above diagnostic IV Iron and NT-ProBNP in HF cutoffs in anemic patients even without CHF. This is independent of gender, BMI, renal function, LV hypertrophy, and/or valve disease (26). In the present study, IV iron therapy substantially reduced NT-proBNP level, and there was a significant negative correlation between Hb and NT-proBNP in both groups, not only at baseline but also at the end of the study.…”

Section: Patient Medicationmentioning

confidence: 40%

Intravenous Iron Reduces NT-Pro-Brain Natriuretic Peptide in Anemic Patients With Chronic Heart Failure and Renal Insufficiency

Toblli

Lombrana

Duarte

et al. 2007

Journal of the American College of Cardiology

370

355

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Section: Patient Medicationmentioning

confidence: 40%

Intravenous Iron Reduces NT-Pro-Brain Natriuretic Peptide in Anemic Patients With Chronic Heart Failure and Renal Insufficiency

Toblli

Lombrana

Duarte

et al. 2007

Journal of the American College of Cardiology

370

355

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show abstract

“…inverse relationship of NT-proBNP concentrations with Hgb in a group of subjects without heart failure [19]. While that study also excluded patients with renal insufficiency, there was no calculation of the BMI and the data was not segregated between males and females.…”

Section: Discussionmentioning

confidence: 99%

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Omland

Knudsen

et al. 2005

American J Hematol

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While anemia is a significant risk factor for poor outcomes in patients with heart failure (HF), it is not in defined guidelines for HF assessment. B-type natriuretic peptide (BNP) is a marker for diagnosis and management of patients with HF. We determined the incidence of anemia in patients with HF and the relationship between BNP and hemoglobin (Hgb) levels in patients with and without HF. Results from the Breathing Not Properly Multinational Trial consisted of 1586 patients presenting to the emergency department (ED) with dyspnea. Because renal insufficiency is a confounding variable for BNP, patients with a creatinine of ‡2.0 mg/dL were excluded. The remaining data were evaluated from 620 non-HF patients (337 M, 283 F) and 547 HF patients (299 M, 248 F). The New York Heart Association (NYHA) HF classification and ejection fraction by echocardiography were assessed for HF patients. Blood was tested for Hgb, BNP, and creatinine. Using World Health Organization criteria for anemia, we observed that HF patients in NYHA class III or IV had lower mean Hgb levels (12.5 g/dL, P < 0.05) and a higher incidence of anemia (48.2%, P < 0.05) than did HF patients in class I or II (13.4 g/dL and 33.9%, respectively). There was no correlation between Hgb and log BNP for females without HF or the aggregate of all HF patients. In contrast, a significant inverse correlation was observed for males without HF (P < 0.001). Although there were differences in the BMI, age, and estimated glomerular filtration rate (eGFR) versus Hgb observed in this group, the log BNP correlation remained significant after multivariate analysis. A significant inverse correlation for log BNP and Hgb were also observed for diastolic (EF ‡ 50) HF (P < 0.05) that was also not accounted for by the BMI, age, or eGFR. The presence of anemia is associated with worsening HF at ED presentation. For males without HF and diastolic HF patients of both genders, a low Hgb may be a confounding variable toward

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“…An inverse association between hematocrit and NT-proBNP levels has been reported among patients without HF [22,23,24]. One potential mechanism may be that a lower hematocrit level leads to increased plasma volume and cardiac output, followed by increased ventricular wall stress [23,24,25].…”

Section: Discussionmentioning

confidence: 99%

Correlates of N-Terminal Prohormone Brain Natriuretic Peptides in African Americans with Hypertensive Chronic Kidney Disease: The African American Study of Kidney Disease and Hypertension

Contreras

Miller

et al. 2008

Am J Nephrol

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Background/Aims: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) is a marker of cardiac stress and elevated levels are indicative of heart failure. Few correlates of NT-proBNP levels have been identified in persons with moderate chronic kidney disease (CKD), and data from those without heart failure and from African Americans are especially limited. Methods: The African American Study of Kidney Disease and Hypertension (AASK) enrolled nondiabetic African Americans with hypertensive kidney disease (glomerular filtration rate [GFR] = 20–65 ml/min/1.73 m²) and no evidence of clinical heart failure. NT-proBNP was measured in 982 AASK participants. Results: In unadjusted analyses, GFR (r = –0.39; p < 0.001), hematocrit (r = –0.21; p < 0.001) and body mass index (BMI; r = –0.07; p = 0.04) were inversely correlated, and systolic blood pressure (r = 0.30; p < 0.001) and log UPCR (r = 0.32; p < 0.001) were positively correlated with log NT-proBNP levels. After adjustment for potential confounders, lower GFR and hematocrit and higher systolic blood pressure and protein:creatinine ratio remained significantly associated with higher NT-proBNP. Conclusion: Lower GFR and hematocrit, and higher urinary protein excretion may be associated with volume expansion in CKD. These results suggest that these processes are associated with increased NT-proBNP in CKD and may play a role in the development of heart failure.

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Effect of anemia on plasma concentrations of NT-proBNP

Cited by 40 publications

References 32 publications

Intravenous Iron Reduces NT-Pro-Brain Natriuretic Peptide in Anemic Patients With Chronic Heart Failure and Renal Insufficiency

Intravenous Iron Reduces NT-Pro-Brain Natriuretic Peptide in Anemic Patients With Chronic Heart Failure and Renal Insufficiency

Relationship of B‐type natriuretic peptide and anemia in patients with and without heart failure: A substudy from the Breathing Not Properly (BNP) Multinational Study

Correlates of N-Terminal Prohormone Brain Natriuretic Peptides in African Americans with Hypertensive Chronic Kidney Disease: The African American Study of Kidney Disease and Hypertension

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