Published online before print April 3, 2006, doi: 10.1161/01.HYP.0000216794.24161.8c
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(Hypertension. 2006;47:874.)
© 2006 American Heart Association, Inc.
Original Articles |
Amino-Terminal Pro-B-Type Natriuretic Peptide and B-Type Natriuretic Peptide
Biomarkers for Mortality in a Large Community-Based Cohort Free of Heart Failure
From the Cardiorenal Research Laboratory (P.M.M., A.C., F.L.M., M.M.R., J.C.B.), Division of Cardiovascular Diseases (R.J.R., A.C., M.M.R., J.C.B.), and Department of Biostatistics (L.H.U., D.W.M., S.J.J.), Mayo Clinic and Foundation, Rochester, Minn; and Stanley J. Sarnoff Endowment for Cardiovascular Science (P.M.M.), Great Falls, Va.
Correspondence to Paul M. McKie, Mayo Clinic, 200 First St SW, Rochester, MN 55905. E-mail mckie.paul{at}mayo.edu
Recent studies report that, in the absence of heart failure and renal failure, plasma B-type natriuretic peptide (BNP) has prognostic value for mortality. We sought to confirm and extend these previous studies to assess BNP, measured by 3 distinct assays, as a biomarker for mortality in a strategy to enhance efforts at primary prevention and to better understand the clinical phenotype of such subjects at risk. We used a community-based cohort of 2042 subjects from Olmsted County, Minn, and individuals with heart or renal failure were excluded. BNP was assessed using 3 assays including Biosite and Shionogi for mature, biologically active BNP and the Roche assay for apparently nonbiologically active amino-terminal pro-BNP (NT-proBNP). Thorough echocardiographic and clinical data were recorded for all of the participants. Median follow-up for mortality was 5.6 years. BNP by all 3 of the assays was predictive of mortality. NT-proBNP and Biosite assays remained significant even after adjustment for traditional clinical risk factors and echocardiographic abnormalities including left ventricular hypertrophy and diastolic dysfunction. Echocardiography documented widespread structural changes in those with increasing BNP levels yet below levels observed in heart failure. We report in a large, well-characterized community-based cohort, free of heart failure, the first study to compare 3 distinct BNP assays as biomarkers for mortality in the same cohort. Our findings confirm the potential use of NT-proBNP and BNP biomarkers for future events and underscore that these peptides may also serve as biomarkers for underlying cardiac remodeling secondary to diverse cardiovascular disease entities.
Key Words: natriuretic peptide • hypertrophy
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