Risk stratification for cardiovascular events among the general population and among high-risk individuals is of considerable interest because of the potential to help guide use of primary and secondary preventive therapies.
Brain-type natriuretic peptide (BNP; consisting of 2 or more amino acids) and the amino terminal fragment of the prohormone BNP (NT-proBNP; a type of peptide in the blood that is a cardiac biomarker) appear to provide prognostic information in individuals following hospital admission for decompensated heart failure or acute coronary syndrome, and may also be important markers of long-term prognosis.
Kirsten Bibbins-Domingo, Ph.D., M.D., of the University of California, San Francisco, and colleagues assessed the association of plasma NT pro-BNP levels with subsequent cardiovascular events (heart attack, stroke, or heart failure) and death in a group of 987 patients with coronary heart disease (CHD). The participants were followed up for an average of 3.7 years, during which 256 patients (26.2 percent) had a cardiovascular event or died.
The researchers found that each increasing quartile of NT-proBNP level was associated with a greater risk of cardiovascular events or death, with individuals in the highest quartile (19.6 percent event rate) having a nearly 8-fold increased rate of cardiovascular events or death compared with those in the lowest quartile (2.6 percent event rate).
Each incremental increase by a certain level of NT-proBNP was associated with a 2.3-fold increased rate of adverse cardiovascular outcomes, even after adjusting for other prognostic markers, including clinical factors, echocardiographic parameters, ischemia, serum biomarkers and functional limitations.
MEDICA.de; Quelle: JAMA and Archives Journals