N-terminal prohormone B-type natriuretic peptide and cardiovascular risk in stable coronary artery disease: a meta-analysis of nine prospective studies

Rev Cardiovasc Med. 2013;14(2-4):e92-8. doi: 10.3909/ricm0644.

Abstract

To evaluate the prognostic value of N-terminal prohormone B-type natriuretic peptide (NT-proBNP) for patients with stable coronary artery disease, we searched for all published English-language articles indexed in MEDLINE and PubMed through July 2011. Nine independent, prospective, cohort studies that assessed the association between NT-proBNP value and long-term prognosis were identified. The interested endpoints of this meta-analysis were all-cause mortality and cardiovascular mortality and cardiovascular events. A general variance-based method was used to pool the hazard ratio (HR). In a comparison of individuals in the top quartile with those in the bottom quartile of baseline values of NT-proBNP, the combined adjusted HR was 2.74 (95% confidence interval [CI], 1.85-3.62). The combined HRs for the second and third quartiles compared with the first quartile were 1.33 (95% CI, 0.83-1.82) and 1.85 (95% CI, 1.23-2.48), respectively. In a subanalysis grouped by the median value, per 1 standard deviation increase or per 1000 pg/mL increase of NT-proBNP, the overall effect also showed that poor prognosis was significantly increased with the elevation of NT-proBNP (HR, 1.58; 95% CI, 1.16-2.01). Available prospective studies indicated strong associations between the circulating concentration of NT-proBNP and long-term prognosis in patients with stable coronary artery disease.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Biomarkers / blood
  • Chi-Square Distribution
  • Coronary Artery Disease / blood*
  • Coronary Artery Disease / diagnosis
  • Coronary Artery Disease / mortality
  • Humans
  • Natriuretic Peptide, Brain / blood*
  • Odds Ratio
  • Peptide Fragments / blood*
  • Prognosis
  • Prospective Studies
  • Risk Factors
  • Time Factors

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain