Comparative evaluation of B-type natriuretic peptide and mid-regional pro-A-type natriuretic peptide changes from admission to discharge in prognosis of acute decompensated heart failure patients

Clin Lab. 2012;58(5-6):585-9.

Abstract

Background: Mid-regional pro-A-type natriuretic peptide (MRproANP) seems to be non-inferior compared to B-type natriuretic peptide (BNP) for heart failure diagnosis and prognosis; however, no previous studies have investigated the MRproANP in-hospital changes in prognostic role. This study aimed to compare the prognostic accuracy of BNP and MRproANP in-hospital changes in acute decompensated heart failure (ADHF) patients.

Methods: 37 patients with either admission/pre-discharge BNP and MRproANP data, were investigated. The combined endpoint was cardiovascular death/heart transplantation/readmission for HF.

Results: BNP and MRproANP had a median decrease of 55% [72;45] and 21% [40; 11] respectively in event-free patients; BNP decrease of 34% [48; 29] but MRproANP increase of 4% [-7; 25] in patients with cardiovascular events. Prognostic accuracy of deltaBNP and deltaMRproANP was similar.

Conclusions: MRproANP basically trends up in patients with worse outcome and decreases in event-free patients, likely leading to a simpler interpretation although the prognostic accuracy is similar for both peptides.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Aged
  • Atrial Natriuretic Factor / blood*
  • Biomarkers / blood
  • Female
  • Heart Failure / blood*
  • Heart Failure / physiopathology
  • Heart Failure / therapy
  • Humans
  • Length of Stay / statistics & numerical data
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Patient Discharge / statistics & numerical data
  • Predictive Value of Tests
  • Prognosis
  • ROC Curve
  • Reproducibility of Results

Substances

  • Biomarkers
  • NPPA protein, human
  • Natriuretic Peptide, Brain
  • Atrial Natriuretic Factor