Relation of Coronary Atherosclerosis Determined by Electron Beam Computed Tomography and Plasma Levels of N-terminal Pro-Brain Natriuretic Peptide in a Multiethnic Population-Based Sample (The Dallas Heart Study)

Abdullah, Shuaib; Khera, Amit; Das, Sandeep R; Stanek, Harold G.; Canham, Russell M.; Chung, Anne K.; Morrow, David A.; Drazner, Mark H.; McGuire, Darren K.; Lemos, James A. de

doi:10.1016/j.amjcard.2005.06.073

Cited by 77 publications

(58 citation statements)

References 27 publications

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“…Supporting the association between homoarginine and endothelial function, low circulating homoarginine has recently been linked to phenotypes of (sub)clinical atherosclerosis, that is, brachial intima‐media and aortic wall thickness 5, 6. Vascular atherosclerosis triggers myocardial stress and may, by this end, directly activate the cardiac neurohormonal system 25. We and others found a strong association of low homoarginine concentrations and increased levels of BNP 26, 27, 28, 29.…”

Section: Discussionsupporting

confidence: 51%

Low Homoarginine Levels in the Prognosis of Patients With Acute Chest Pain

Atzler

Baum

Ojeda

et al. 2016

JAHA

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BackgroundThe endogenous amino acid homoarginine predicts mortality in cerebro‐ and cardiovascular disease. The objective was to explore whether homoarginine is associated with atrial fibrillation (AF) and outcome in patients with acute chest pain.Methods and ResultsOne thousand six hundred forty‐nine patients with acute chest pain were consecutively enrolled in this study, of whom 589 were diagnosed acute coronary syndrome (ACS). On admission, plasma concentrations of homoarginine as well as brain natriuretic peptide (BNP), and high‐sensitivity assayed troponin I (hsTnI) were determined along with electrocardiography (ECG) variables. During a median follow‐up of 183 days, 60 major adverse cardiovascular events (MACEs; 3.8%), including all‐cause death, myocardial infarction, or stroke, were registered in the overall study population and 43 MACEs (7.5%) in the ACS subgroup. Adjusted multivariable Cox regression analyses revealed that an increase of 1 SD of plasma log‐transformed homoarginine (0.37) was associated with a hazard reduction of 26% (hazard ratio [HR], 0.74; 95% CI, 0.57–0.96) for incident MACE and likewise of 35% (HR, 0.65; 95% CI, 0.49–0.88) in ACS patients. In Kaplan–Meier survival curves, homoarginine was predictive for patients with high‐sensitivity assayed troponin I (hsTnI) above 27 ng/L (P<0.05). Last, homoarginine was inversely associated with QTc duration (P<0.001) and prevalent AF (OR, 0.83; 95% CI, 0.71–0.95).ConclusionLow plasma homoarginine was identified as a risk marker for incident MACEs in patients with acute chest pain, in particular, in those with elevated hsTnI. Impaired homoarginine was associated with prevalent AF. Further studies are needed to investigate the link to AF and evaluate homoarginine as a therapeutic option for these patients.

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Section: Discussionsupporting

confidence: 51%

Low Homoarginine Levels in the Prognosis of Patients With Acute Chest Pain

Atzler

Baum

Ojeda

et al. 2016

JAHA

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“…[16][17][18] Nevertheless, given the statistically significant associations between indices of renal function and NT-proBNP (log BUN and log creatinine on univariate analysis, and log BUN on multivariate analysis), it is possible that reduced clearance of the peptide contributed also to the observed intergroup difference in NT-proBNP levels. The magnitude of any such contribution is difficult to gauge, however, since details of how NT-proBNP is cleared from the circulation remain to be defined.…”

Section: Discussionmentioning

confidence: 99%

“…28,30 Regarding our second observation, there is little information, to our awareness, relating circulating levels of the cardiac natriuretic peptides to ethnicity. In a study of coronary atherosclerosis (as determined by electron beam computed tomography), Abdullah et al 17,31 reported that plasma NT-proBNP levels were slightly, but significantly, lower in African Americans than Caucasians (median 30.6 versus 24.5 pg/ml, Po0.004, n ¼ 1275 and 1394, respectively). For patients presenting with an emergency diagnosis of heart failure, Maisel et al 32 likewise observed lower plasma natriuretic peptide levels, BNP in this case, in African Americans than Caucasians (median 117 versus 200 pg/ml, Po0.001, n ¼ 715 and 773, respectively).…”

Section: Discussionmentioning

confidence: 99%

Plasma N terminal pro-brain natriuretic peptide levels and its determinants in a multi-ethnic population

et al. 2007

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This study documents the determinants and plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) among hypertensive and normotensive subjects in a multi-ethnic population in the United Arab Emirates (UAE). We obtained demographic, anthropometric and clinical data, together with fasting NT-proBNP and biochemical indices from 128 hypertensive patients and 138 normotensive subjects matched for age, gender and ethnicity. Plasma NT-proBNP levels were significantly (Po0.001), and several-fold higher among hypertensives (median 5.92, inter quartile range (IQR): 1.79-18.48 pmol/l) than normotensives (median 1.78, IQR: 0.59-4.32 pmol/l) in the total study population, and the same was true for the ethnic groups separately. Similarly, plasma levels of glucose, blood urea nitrogen (BUN) and creatinine, but not insulin, were significantly (Po0.05) higher among hypertensives than normotensives. For all subjects combined, log NT-proBNP correlated positively and significantly with age (Po0.01), log glucose (Po0.05), systolic blood pressure (SBP, Po0.001), log BUN (Po0.001) and log creatinine (Po0.001). Multivariate regression analysis showed that NT-proBNP levels were independently and positively correlated with SBP, age, gender, log BUN, Emirati and South East Asian ethnic groups and inversely associated with current exercise. In conclusion, we found circulating levels of NT-proBNP to be significantly increased in hypertensive versus normotensive subjects in the UAE and independently related to SBP, age, gender, indices of renal function and possibly exercise. Our results further suggest a possible modulating effect of ethnicity on NT-proBNP levels.

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“…Thus, among the parameters related to arterial stiffness/central hemodynamic indices, PP2, a marker of the central PP, might be related to the LV afterload, which could explain the significantly close relationship of the PP2 with the serum NT-pro BNP levels; and (2) several studies have demonstrated that elevated serum NT-pro BNP is also a risk factor for cardiovascular diseases other than heart failure, 1,24 and Abdullah et al reported the existence of an association between the serum NT-pro BNP levels and coronary atherosclerosis. 25 In addition, Roman et al also reported that CPP (pulsatile stress) is a more important determinant of vascular hypertrophy and atherosclerosis as compared to the systolic pressure (systolic stress). 26 Therefore, PP2 and serum NT-pro BNP levels might be markers, at least in part, of similar facets of vascular damage.…”

Section: Discussionmentioning

confidence: 99%