Serial Measurements of N-Terminal Pro-Brain Natriuretic Peptide in Patients with Coronary Heart Disease
To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease. NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilita...
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| Published in | PloS one Vol. 10; no. 1; p. e0117143 |
|---|---|
| Main Authors | , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Public Library of Science
28.01.2015
Public Library of Science (PLoS) |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1932-6203 1932-6203 |
| DOI | 10.1371/journal.pone.0117143 |
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| Abstract | To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease.
NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline.
Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33-2.05] vs. HR 1.41 [95% CI 1.12-1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002-0.194] compared to NRI of 0.047 [95% CI -0.0004-0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12-1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10-5.95] compared to those with the highest 12-months reduction.
Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. |
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| AbstractList | To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease. NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline. Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33-2.05] vs. HR 1.41 [95% CI 1.12-1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002-0.194] compared to NRI of 0.047 [95% CI -0.0004-0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12-1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10-5.95] compared to those with the highest 12-months reduction. Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease.OBJECTIVETo assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease.NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline.METHODSNT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline.Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33-2.05] vs. HR 1.41 [95% CI 1.12-1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002-0.194] compared to NRI of 0.047 [95% CI -0.0004-0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12-1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10-5.95] compared to those with the highest 12-months reduction.RESULTSAmong 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33-2.05] vs. HR 1.41 [95% CI 1.12-1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002-0.194] compared to NRI of 0.047 [95% CI -0.0004-0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12-1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10-5.95] compared to those with the highest 12-months reduction.Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors.CONCLUSIONSTwelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. ObjectiveTo assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease.MethodsNT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline.ResultsAmong 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33-2.05] vs. HR 1.41 [95% CI 1.12-1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002-0.194] compared to NRI of 0.047 [95% CI -0.0004-0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12-1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10-5.95] compared to those with the highest 12-months reduction.ConclusionsTwelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. Objective To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease. Methods NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline. Results Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33–2.05] vs. HR 1.41 [95% CI 1.12–1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002–0.194] compared to NRI of 0.047 [95% CI −0.0004–0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12–1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10–5.95] compared to those with the highest 12-months reduction. Conclusions Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease. NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline. Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33-2.05] vs. HR 1.41 [95% CI 1.12-1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002-0.194] compared to NRI of 0.047 [95% CI -0.0004-0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12-1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10-5.95] compared to those with the highest 12-months reduction. Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. Objective To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease. Methods NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline. Results Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33-2.05] vs. HR 1.41 [95% CI 1.12-1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002-0.194] compared to NRI of 0.047 [95% CI -0.0004-0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12-1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10-5.95] compared to those with the highest 12-months reduction. Conclusions Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. Objective To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with stable coronary heart disease. Methods NT-proBNP concentrations were measured at baseline and at 12-months follow-up in participants of cardiac rehabilitation (median follow-up 8.96 years). Cox-proportional hazards models evaluated the prognostic value of log-transformed NT-proBNP levels, and of 12-months NT-proBNP relative changes on adverse cardiovascular events adjusting for established risk factors measured at baseline. Results Among 798 participants (84.7% men, mean age 59 years) there were 114 adverse cardiovascular events. 12-months NT-proBNP levels were higher than baseline levels in 60 patients (7.5%) and numerically more strongly associated with the outcome in multivariable analysis (HR 1.65 [95% CI 1.33–2.05] vs. HR 1.41 [95% CI 1.12–1.78], with a net reclassification improvement (NRI) of 0.098 [95% CI 0.002–0.194] compared to NRI of 0.047 [95% CI −0.0004–0.133] for baseline NT-proBNP levels. A 12-month 10% increment of NT-proBNP was associated with a HR of 1.35 [95% CI 1.12–1.63] for the onset of an adverse cardiovascular event. Subjects with a 12-month increment of NT-proBNP had a HR of 2.56 [95% CI 1.10–5.95] compared to those with the highest 12-months reduction. Conclusions Twelve-months NT-proBNP levels after an acute cardiovascular event are strongly associated with a subsequent event and may provide numerically better reclassification of patients at risk for an adverse cardiovascular event compared to NT-proBNP baseline levels after adjustment for established risk factors. |
| Audience | Academic |
| Author | Dallmeier, Dhayana Koenig, Wolfgang Rothenbacher, Dietrich Rajman, Iris Pencina, Michael J. Brenner, Hermann |
| AuthorAffiliation | 1 University of Ulm Medical Center, Department of Internal Medicine II-Cardiology, Ulm, Germany 2 Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America 3 Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany 5 Novartis Institute of Biomedical Research, Basel, Switzerland 6 German Cancer Research Center, Division of Clinical Epidemiology & Aging Research, Heidelberg, Germany Medical University Hamburg, University Heart Center, GERMANY 4 Duke Clinical Research Institute, Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, United States of America |
| AuthorAffiliation_xml | – name: 2 Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States of America – name: 3 Ulm University, Institute of Epidemiology and Medical Biometry, Ulm, Germany – name: 1 University of Ulm Medical Center, Department of Internal Medicine II-Cardiology, Ulm, Germany – name: 6 German Cancer Research Center, Division of Clinical Epidemiology & Aging Research, Heidelberg, Germany – name: Medical University Hamburg, University Heart Center, GERMANY – name: 4 Duke Clinical Research Institute, Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, United States of America – name: 5 Novartis Institute of Biomedical Research, Basel, Switzerland |
| Author_xml | – sequence: 1 givenname: Dhayana surname: Dallmeier fullname: Dallmeier, Dhayana – sequence: 2 givenname: Michael J. surname: Pencina fullname: Pencina, Michael J. – sequence: 3 givenname: Iris surname: Rajman fullname: Rajman, Iris – sequence: 4 givenname: Wolfgang surname: Koenig fullname: Koenig, Wolfgang – sequence: 5 givenname: Dietrich surname: Rothenbacher fullname: Rothenbacher, Dietrich – sequence: 6 givenname: Hermann surname: Brenner fullname: Brenner, Hermann |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25629613$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_1002_ehf2_13834 crossref_primary_10_1016_j_ajpc_2023_100528 crossref_primary_10_1161_JAHA_118_011882 crossref_primary_10_3390_biom11020230 crossref_primary_10_1371_journal_pone_0242814 crossref_primary_10_1109_ACCESS_2020_3007988 crossref_primary_10_1373_clinchem_2016_263202 crossref_primary_10_1093_jalm_jfad024 crossref_primary_10_3390_jcm9103107 |
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| DocumentTitleAlternate | Prognostic Value of Serial NT-proBNP Measurements |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 Conceived and designed the experiments: DD MJP WK DR. Analyzed the data: DD MJP WK DR HB. Contributed reagents/materials/analysis tools: MJP WK IR DR HB. Wrote the paper: DD MJP WK IR DR HB. Competing Interests: Prof. Dr. D. Rothenbacher is a member of the Advisory Board at AbbVie, Novartis Pharma, and Dr. I. Rajman is a full-time employee of Novartis at the Institute of Biomedical Research. This does not alter the authors’ adherence to PLOS ONE policies on sharing data and materials. |
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| Snippet | To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients with... Objective To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients... ObjectiveTo assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients... Objective To assess the prognostic value of 12-months N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) levels on adverse cardiovascular events in patients... |
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| SubjectTerms | Acute coronary syndromes Aged Analysis Biomarkers Biomarkers - blood Biometrics Brain Brain natriuretic peptide Brain research Cardiac patients Cardiology Cardiovascular disease Cardiovascular diseases Cardiovascular Diseases - blood Cardiovascular Diseases - diagnosis Coronary artery disease Coronary Disease - blood Coronary heart disease Diabetes Epidemiology Family medical history Female Hazards Health risk assessment Health risks Heart Heart attacks Heart diseases Hospitals Humans Internal medicine Ischemia Male Measurement Measurement methods Medical research Middle Aged Mortality Natriuretic Peptide, Brain - blood Natriuretic peptides Older people Patients Peptide Fragments - blood Peptides Prognosis Proteins Reclassification Rehabilitation Risk analysis Risk Assessment Risk Factors Statistical models |
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| Title | Serial Measurements of N-Terminal Pro-Brain Natriuretic Peptide in Patients with Coronary Heart Disease |
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