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Prognostic role of molecular forms of B-type natriuretic peptide in acute heart failure
journal contribution
posted on 2018-06-05, 08:36 authored by Toru Suzuki, M. Zubair Israr, Liam HeaneyLiam Heaney, Minoru Takaoka, Iain B. Squire, Leong L. Ng© 2016 American Association for Clinical Chemistry. BACKGROUND: B-type natriuretic peptide (BNP) molecular forms 5-32, 4-32, and 3-32 are known to be present in the circulation of heart failure (HF) patients. This study investigated the prognostic role of circulating BNP molecular forms on risk prediction for patients with acute HF. METHODS: BNP molecular forms were measured in plasma using an immunocapture MALDI-TOF-mass spectrometry (MS) method. Associations of molecular BNP forms with adverse outcome of all-cause mortality (death) and a composite of all-cause mortality and rehospitalization due to HF (death/HF) at 6 months and 1 year were investigated. RESULTS: BNP molecular forms 5-32, 4-32, and 3-32 were detected in 838 out of 904 patient samples. BNP molecular forms were all able to independently predict death and death/HF at 6 months and 1 year. BNP 5-32 was the superior form with strongest predictive qualities for death at 6 months [adjusted hazard ratio (HR) 1.31, P = 0.005] and 1 year (adjusted HR 1.29, P=0.002) and death/HF at 1 year (adjusted HR 1.18, P = 0.011). BNP 5-32, 4-32, and 3-32 showed decreased survival rates across increasing tertiles of circulating concentrations (P ≤ 0.004). BNP molecular forms showed prognostic ability comparable with conventional BNP measurements across all end points (P = 0.002- 0.032 vs P = 0.014 - 0.039, respectively) and reduced associations with renal dysfunction (blood urea; Spearman correlation r s = 0.187- 0.246 vs r s = 0.369, respectively). CONCLUSIONS: BNP molecular forms, notably BNP 5-32, showed association with poor prognosis at 6 months and 1 year in patients with acute HF. This is the first study reporting the prognostic ability of molecular BNP forms in HF patients and demonstrated comparable qualities to conventional BNP measurements.
Funding
This work was supported by the Practical Research Project for Life-Style related Diseases including Cardiovascular Diseases and Diabetes Mellitus from Japan Agency for Medical Research and Development (AMED) and the University of Tokyo, the John and Lucille van Geest Foundation and the National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit.
History
School
- Sport, Exercise and Health Sciences
Published in
Clinical ChemistryVolume
63Issue
4Pages
880 - 886Citation
SUZUKI, T. ... et al., 2017. Prognostic role of molecular forms of B-type natriuretic peptide in acute heart failure. Clinical Chemistry, 63(4), pp. 880-886.Publisher
© American Association for Clinical ChemistryVersion
- AM (Accepted Manuscript)
Publisher statement
This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at: https://creativecommons.org/licenses/by-nc-nd/4.0/Acceptance date
2016-12-01Publication date
2017-03-31Notes
This work is in closed access.ISSN
0009-9147eISSN
1530-8561Publisher version
Language
- en