Joint Effects of N-Terminal Pro-B-Type-Natriuretic Peptide and C-Reactive Protein vs Angiographic Severity in Predicting Major Adverse Cardiovascular Events and Clinical Restenosis After Coronary Angioplasty in Patients With Stable Coronary Artery Disease

Dai, Dao Fu; Hwang, Juey‐Jen; Lin, Jiunn Lee; Lin, Jia‐Hua; Hsu, Chih Neng; Lin, Chih Min; Chiang, Fu-Tien; Lai, Ling‐Ping; Hsu, Kwan Lih; Tseng, Chuen Den; Tseng, Yung Zu

doi:10.1253/circj.72.1316

Cited by 14 publications

(10 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Twenty-three studies were based in Europe, 8 -28,46,47 5 in North America, 29 -33 1 in Australia and New Zealand, 34 and 7 in East Asia [35][36][37][38][39][40]45 (predominantly in Japan), and 4 were multinational. [41][42][43][44] Thirty-six studies were prospective cohorts and 4 "nested" case-control studies; 14 studies recruited participants from population registers (such as general practitioners' lists or electoral rolls), and 26 were hospital based (of which 10 were clinical trials).…”

Section: Resultsmentioning

confidence: 99%

“…Furthermore, although BNP and NT-proBNP have different plasma half-lives (Ϸ20 minutes versus Ϸ90 minutes, respectively) and differ in range of circulating values, 2 the Olsen 20 Olsen/LIFE 19 Astor 29 Dai 35 Pfister 21 Rothenbacher 23 …”

Section: Discussionmentioning

confidence: 99%

“…Fourteen studies reported on changes in measures of risk discrimination upon the addition of either BNP or NT- 16,17,21,23,30,35,41,43 Most studies used a core set of variables (ie, age, sex, smoking, diabetes mellitus, blood pressure, total cholesterol, high-density lipoprotein cholesterol) in their basic risk prediction models but differed in the use of additional characteristics, which ranged from drug treatments (eg, lipid-lowering medication) to lifestyle factors (eg, physical activity) to physical measurements (eg, adiposity markers) to various biochemical factors (eg, C-reactive protein). Studies reported findings in relation to CVD risk discrimination as area under the receiveroperator characteristics curve or the C index.…”

Section: Cvd Risk Discrimination Modelsmentioning

confidence: 99%

See 2 more Smart Citations

B-Type Natriuretic Peptides and Cardiovascular Risk

et al. 2009

View full text Add to dashboard Cite

Background-Measurement of B-type natriuretic peptide (BNP) concentration or its precursor (N-terminal fragment [NT-proBNP]) is recommended in patients with symptoms of left ventricular dysfunction and in other settings, but the relevance of these peptides to cardiovascular disease (CVD) in general populations or in patients with stable vascular disease is uncertain. Methods and Results-Data were collated from 40 long-term prospective studies involving a total of 87 474 participants and 10 625 incident CVD outcomes. In a comparison of individuals in the top third with those in the bottom third of baseline values of natriuretic peptides, the combined risk ratio (RR), adjusted for several conventional risk factors, was 2.82 (95% confidence interval [CI], 2.40 to 3.33) for CVD. Analysis of the 6 studies with at least 250 CVD outcomes (which should be less prone to selective reporting than are smaller studies) yielded an adjusted RR of 1. Key Words: cardiovascular diseases Ⅲ meta-analysis Ⅲ natriuretic peptides B -type natriuretic peptide (BNP) is a 32-amino acid polypeptide secreted by ventricular myocytes during periods of increased ventricular stretch and wall tension. This peptide is believed to play an important role in the regulation of blood pressure, blood volume, and sodium balance. On secretion, the BNP precursor is split into the biologically active peptide and the more stable N-terminal fragment (NT-proBNP). 1,2 Measurement of circulating levels of BNP or NT-proBNP has been recommended in the diagnosis and prognosis of patients with symptoms of left ventricular dysfunction 3 and for stratification of risk in patients with acute coronary syndromes. 4,5 Because in vitro studies have reported that natriuretic peptides are directly released from cardiomyocytes in response to myocardial ischemia, 6,7 it has been proposed that their circulating levels are relevant to subsequent risk of cardiovascular diseases (CVDs) other than heart failure. Clinical Perspective on p 2187Although many prospective studies have investigated concentrations of natriuretic peptides in relation to the subsequent risk of CVD (eg, coronary heart disease [CHD] or stroke), most of them have not been systematically assessed. 8 -47 Two previous relevant reviews (in total involving 11 studies 48,49 ) involved only about one sixth of the currently available data. Interpretation of the evidence has been complicated by studies that have involved different markers (ie, BNP, NT-proBNP, or both), populations with different base- We report an updated meta-analysis of findings from 40 long-term prospective studies of BNP and NT-proBNP involving a total of 87 474 individuals, including 10 625 incident CVD outcomes, in 3 distinct groups: participants from approximately general populations, people selected on the basis of elevated CVD risk factors, and patients with stable CVD at study entry. Methods Study SelectionWe sought prospective studies that had been published before July 2009 and reported on associations of circulating BNP and/or NTproBNP w...

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Cvd Risk Discrimination Modelsmentioning

confidence: 99%

See 1 more Smart Citation

B-Type Natriuretic Peptides and Cardiovascular Risk

et al. 2009

View full text Add to dashboard Cite

show abstract

“…In the present study, neither the OPN nor the hsCRP level was high in patients with restenosis, nor were they independent predictors for restenosis. High preprocedural hsCRP levels related to the development of restenosis have been reported in a few studies, 18,19 but many other studies have not found such a relationship, [20][21][22][23] instead showing that hsCRP levels predict adverse cardiovascular events, but not restenosis, in patients undergoing PCI. [18][19][20][21][22][23] Our study is the first to demonstrate that the preprocedural levels of hsCRP and OPN were high in patients who suffered postprocedural MACE and are independent predictors for MACE in patients undergoing PCI.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Significance of Plasma Osteopontin Levels in Patients Undergoing Percutaneous Coronary Intervention

Kato

Momiyama

Ohmori

et al. 2009

Circ J

View full text Add to dashboard Cite

Background Osteopontin (OPN) mRNA is highly expressed in atherosclerotic plaques and plasma OPN levels are high in patients with coronary artery disease and in those with restenosis. OPN-overexpressing transgenic mice show markedly increased neointimal formation after arterial injury. Methods and ResultsThe prognostic significance of the preprocedural plasma OPN level was investigated in 130 patients undergoing percutaneous coronary intervention (PCI). Patients were followed up for restenosis and major adverse cardiovascular events (MACE). At 7±3 months after PCI, angiography was performed again in 91 patients, of whom 40 had restenosis. Between patients with and without restenosis, OPN (492±200 vs 482±224 ng/ml) and C-reactive protein (CRP: 0.78 vs 0.70 mg/L) levels did not differ. During a 3-year follow-up, MACE occurred in 21 patients, who had higher OPN (586±230 vs 438±195 ng/ml) and CRP (1.30 vs 0.70 mg/L) levels than those without MACE (P<0.005). Both OPN and CRP levels were independent predictors for MACE. Hazard ratios for MACE were 1.3 (95% confidence interval (CI) 1.1-1.5) for a 100 ng/ml increase in OPN and 3.6 (95%CI 1.4-9.3) for CRP >1.0 mg/L. Conclusions In patients undergoing PCI, the preprocedural OPN and CRP levels are independent predictors for further cardiovascular events, but not for restenosis. (Circ J 2009; 73: 152 -157)

show abstract

“…[5][6][7] Enhanced erythropoiesis results in an increase in the heterogeneity of circulating erythrocytes. 8) Finally, there is increasing evidence that a chronic inflammatory state and neurohumoral activation each contribute to adverse clinical outcomes in patients with CAD [9][10][11][12] and those with heart failure. [13][14][15][16] Accordingly, we hypothesized that inflammatory and neurohumoral activation may be a mechanistic link between higher RDW and increased mortality in patients with CAD.…”

mentioning

confidence: 99%

Elevated Plasma Levels of B-Type Natriuretic Peptide but Not C-Reactive Protein Are Associated With Higher Red Cell Distribution Width in Patients With Coronary Artery Disease

et al. 2009

View full text Add to dashboard Cite

SummaryAlthough higher red cell distribution width (RDW) has recently been reported to be associated with increased mortality independent of anemia in patients with heart failure and those with coronary artery disease (CAD), the mechanism underlying this association is unknown. We hypothesized that higher RDW may reflect neurohumoral activation and a chronic inflammatory state that each contribute to adverse clinical outcomes in these populations. We measured RDW and plasma levels of B-type natriuretic peptide (BNP) and high-sensitive C-reactive protein (hs-CRP) in 226 consecutive patients undergoing cardiac catheterization for CAD (age, 67 ± 8 years; males, 77%; RDW, 45.8 ± 3.3 fL; hemoglobin, 13.2 ± 1.4 g/dL; BNP, median [interquartile range], 26.0 [9.0-58.4] pg/mL; hs-CRP, 679 ng/mL).Plasma BNP (r = 0.21, P < 0.01) but not hs-CRP (r = 0.04, P > 0.1) levels correlated with RDW. After adjustment for potential confounders including age, gender, body mass index, glomerular filtration rate, hemoglobin, and known hemodynamic determinants of BNP, including elevated left ventricular end-diastolic pressure and volume and slow left ventricular relaxation, RDW was independently predicted by BNP (r 2 = 0.058, P < 0.001).In conclusion, elevated BNP levels are independently associated with higher RDW in patients with CAD. Neurohumoral activation may be a mechanistic link between increased RDW and adverse clinical outcomes in this population. (Int Heart J 2009; 50: 301-312)

show abstract

Joint Effects of N-Terminal Pro-B-Type-Natriuretic Peptide and C-Reactive Protein vs Angiographic Severity in Predicting Major Adverse Cardiovascular Events and Clinical Restenosis After Coronary Angioplasty in Patients With Stable Coronary Artery Disease

Cited by 14 publications

References 37 publications

B-Type Natriuretic Peptides and Cardiovascular Risk

B-Type Natriuretic Peptides and Cardiovascular Risk

Prognostic Significance of Plasma Osteopontin Levels in Patients Undergoing Percutaneous Coronary Intervention

Elevated Plasma Levels of B-Type Natriuretic Peptide but Not C-Reactive Protein Are Associated With Higher Red Cell Distribution Width in Patients With Coronary Artery Disease

Contact Info

Product

Resources

About