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Prediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects With Cerebrovascular Disease

B-type natriuretic peptide (BNP) and C-reactive protein (CRP) are elevated in persons at risk for congestive heart failure (CHF). However, limited data are available directly comparing BNP-related peptides and CRP in persons at risk of CHF. To evaluate amino terminal–pro-BNP (NT-proBNP) and CRP, sep... Full description

Journal Title: Hypertension 2005-01-01, Vol.45 (1), p.69-74
Main Author: Campbell, Duncan J
Other Authors: Woodward, Mark , Chalmers, John P , Colman, Samuel A , Jenkins, Alicia J , Kemp, Bruce E , Neal, Bruce C , Patel, Anushka , MacMahon, Stephen W
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: Philadelphia, PA: Am Heart Assoc
ID: ISSN: 0194-911X
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title: Prediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects With Cerebrovascular Disease
format: Article
creator:
  • Campbell, Duncan J
  • Woodward, Mark
  • Chalmers, John P
  • Colman, Samuel A
  • Jenkins, Alicia J
  • Kemp, Bruce E
  • Neal, Bruce C
  • Patel, Anushka
  • MacMahon, Stephen W
subjects:
  • Aged
  • Angiotensin-Converting Enzyme Inhibitors - therapeutic use
  • Antihypertensive Agents - therapeutic use
  • Arterial hypertension. Arterial hypotension
  • Biological and medical sciences
  • Biomarkers
  • Blood and lymphatic vessels
  • C-Reactive Protein - analysis
  • Cardiology. Vascular system
  • Cardiotonic agents
  • Cardiovascular system
  • Case-Control Studies
  • Cerebrovascular Disorders - blood
  • Cerebrovascular Disorders - epidemiology
  • Experimental diseases
  • Female
  • Follow-Up Studies
  • Heart Failure - blood
  • Heart Failure - epidemiology
  • Humans
  • Hypertension - drug therapy
  • Hypertension - epidemiology
  • Incidence
  • Ischemic Attack, Transient - blood
  • Ischemic Attack, Transient - epidemiology
  • Male
  • Medical sciences
  • Middle Aged
  • Natriuretic Peptide, Brain
  • Nerve Tissue Proteins - blood
  • Peptide Fragments - blood
  • Perindopril - therapeutic use
  • Pharmacology. Drug treatments
  • Predictive Value of Tests
  • Prognosis
  • Prospective Studies
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Sensitivity and Specificity
  • Stroke - blood
  • Stroke - epidemiology
ispartof: Hypertension, 2005-01-01, Vol.45 (1), p.69-74
description: B-type natriuretic peptide (BNP) and C-reactive protein (CRP) are elevated in persons at risk for congestive heart failure (CHF). However, limited data are available directly comparing BNP-related peptides and CRP in persons at risk of CHF. To evaluate amino terminal–pro-BNP (NT-proBNP) and CRP, separately and together, for assessment of risk of CHF, we performed a nested case-control study of the 6105 participants of the Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS), a placebo-controlled study of a perindopril-based blood pressure–lowering regimen among individuals with previous stroke or transient ischemic attack (TIA). Each of 258 subjects who developed CHF resulting in death, hospitalization, or withdrawal of randomized therapy during a mean follow-up of 3.9 years was matched to 1 to 3 control subjects. NT-proBNP and CRP predicted CHF; the odds ratio for subjects in the highest compared with the lowest quarter was 4.5 (95% confidence interval, 2.7 to 7.5) for NT-proBNP and 2.9 (confidence interval, 1.9 to 4.7) for CRP, and each remained a predictor of CHF after adjustment for all other predictors. Screening for both markers provided better prognostic information than screening for either alone. Elevation of NT-proBNP above 50 pmol/L and CRP above 0.84 mg/L predicted CHF with sensitivity of 64% and specificity of 66%. NT-proBNP and CRP predicted CHF in subjects receiving perindopril-based therapy. We conclude that NT-proBNP and CRP are independent predictors of CHF risk after stroke or TIA. Moreover, NT-proBNP and CRP may be markers of mechanisms of CHF pathogenesis distinct from those responsive to angiotensin-converting enzyme inhibitor–based therapy.
language: eng
source:
identifier: ISSN: 0194-911X
fulltext: no_fulltext
issn:
  • 0194-911X
  • 1524-4563
url: Link


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titlePrediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects With Cerebrovascular Disease
creatorCampbell, Duncan J ; Woodward, Mark ; Chalmers, John P ; Colman, Samuel A ; Jenkins, Alicia J ; Kemp, Bruce E ; Neal, Bruce C ; Patel, Anushka ; MacMahon, Stephen W
creatorcontribCampbell, Duncan J ; Woodward, Mark ; Chalmers, John P ; Colman, Samuel A ; Jenkins, Alicia J ; Kemp, Bruce E ; Neal, Bruce C ; Patel, Anushka ; MacMahon, Stephen W
descriptionB-type natriuretic peptide (BNP) and C-reactive protein (CRP) are elevated in persons at risk for congestive heart failure (CHF). However, limited data are available directly comparing BNP-related peptides and CRP in persons at risk of CHF. To evaluate amino terminal–pro-BNP (NT-proBNP) and CRP, separately and together, for assessment of risk of CHF, we performed a nested case-control study of the 6105 participants of the Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS), a placebo-controlled study of a perindopril-based blood pressure–lowering regimen among individuals with previous stroke or transient ischemic attack (TIA). Each of 258 subjects who developed CHF resulting in death, hospitalization, or withdrawal of randomized therapy during a mean follow-up of 3.9 years was matched to 1 to 3 control subjects. NT-proBNP and CRP predicted CHF; the odds ratio for subjects in the highest compared with the lowest quarter was 4.5 (95% confidence interval, 2.7 to 7.5) for NT-proBNP and 2.9 (confidence interval, 1.9 to 4.7) for CRP, and each remained a predictor of CHF after adjustment for all other predictors. Screening for both markers provided better prognostic information than screening for either alone. Elevation of NT-proBNP above 50 pmol/L and CRP above 0.84 mg/L predicted CHF with sensitivity of 64% and specificity of 66%. NT-proBNP and CRP predicted CHF in subjects receiving perindopril-based therapy. We conclude that NT-proBNP and CRP are independent predictors of CHF risk after stroke or TIA. Moreover, NT-proBNP and CRP may be markers of mechanisms of CHF pathogenesis distinct from those responsive to angiotensin-converting enzyme inhibitor–based therapy.
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languageeng
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subjectAged ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Antihypertensive Agents - therapeutic use ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Biomarkers ; Blood and lymphatic vessels ; C-Reactive Protein - analysis ; Cardiology. Vascular system ; Cardiotonic agents ; Cardiovascular system ; Case-Control Studies ; Cerebrovascular Disorders - blood ; Cerebrovascular Disorders - epidemiology ; Experimental diseases ; Female ; Follow-Up Studies ; Heart Failure - blood ; Heart Failure - epidemiology ; Humans ; Hypertension - drug therapy ; Hypertension - epidemiology ; Incidence ; Ischemic Attack, Transient - blood ; Ischemic Attack, Transient - epidemiology ; Male ; Medical sciences ; Middle Aged ; Natriuretic Peptide, Brain ; Nerve Tissue Proteins - blood ; Peptide Fragments - blood ; Perindopril - therapeutic use ; Pharmacology. Drug treatments ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Randomized Controlled Trials as Topic ; Risk Factors ; Sensitivity and Specificity ; Stroke - blood ; Stroke - epidemiology
ispartofHypertension, 2005-01-01, Vol.45 (1), p.69-74
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0Campbell, Duncan J
1Woodward, Mark
2Chalmers, John P
3Colman, Samuel A
4Jenkins, Alicia J
5Kemp, Bruce E
6Neal, Bruce C
7Patel, Anushka
8MacMahon, Stephen W
title
0Prediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects With Cerebrovascular Disease
1Hypertension
addtitleHypertension
descriptionB-type natriuretic peptide (BNP) and C-reactive protein (CRP) are elevated in persons at risk for congestive heart failure (CHF). However, limited data are available directly comparing BNP-related peptides and CRP in persons at risk of CHF. To evaluate amino terminal–pro-BNP (NT-proBNP) and CRP, separately and together, for assessment of risk of CHF, we performed a nested case-control study of the 6105 participants of the Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS), a placebo-controlled study of a perindopril-based blood pressure–lowering regimen among individuals with previous stroke or transient ischemic attack (TIA). Each of 258 subjects who developed CHF resulting in death, hospitalization, or withdrawal of randomized therapy during a mean follow-up of 3.9 years was matched to 1 to 3 control subjects. NT-proBNP and CRP predicted CHF; the odds ratio for subjects in the highest compared with the lowest quarter was 4.5 (95% confidence interval, 2.7 to 7.5) for NT-proBNP and 2.9 (confidence interval, 1.9 to 4.7) for CRP, and each remained a predictor of CHF after adjustment for all other predictors. Screening for both markers provided better prognostic information than screening for either alone. Elevation of NT-proBNP above 50 pmol/L and CRP above 0.84 mg/L predicted CHF with sensitivity of 64% and specificity of 66%. NT-proBNP and CRP predicted CHF in subjects receiving perindopril-based therapy. We conclude that NT-proBNP and CRP are independent predictors of CHF risk after stroke or TIA. Moreover, NT-proBNP and CRP may be markers of mechanisms of CHF pathogenesis distinct from those responsive to angiotensin-converting enzyme inhibitor–based therapy.
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0Aged
1Angiotensin-Converting Enzyme Inhibitors - therapeutic use
2Antihypertensive Agents - therapeutic use
3Arterial hypertension. Arterial hypotension
4Biological and medical sciences
5Biomarkers
6Blood and lymphatic vessels
7C-Reactive Protein - analysis
8Cardiology. Vascular system
9Cardiotonic agents
10Cardiovascular system
11Case-Control Studies
12Cerebrovascular Disorders - blood
13Cerebrovascular Disorders - epidemiology
14Experimental diseases
15Female
16Follow-Up Studies
17Heart Failure - blood
18Heart Failure - epidemiology
19Humans
20Hypertension - drug therapy
21Hypertension - epidemiology
22Incidence
23Ischemic Attack, Transient - blood
24Ischemic Attack, Transient - epidemiology
25Male
26Medical sciences
27Middle Aged
28Natriuretic Peptide, Brain
29Nerve Tissue Proteins - blood
30Peptide Fragments - blood
31Perindopril - therapeutic use
32Pharmacology. Drug treatments
33Predictive Value of Tests
34Prognosis
35Prospective Studies
36Randomized Controlled Trials as Topic
37Risk Factors
38Sensitivity and Specificity
39Stroke - blood
40Stroke - epidemiology
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3Colman, Samuel A
4Jenkins, Alicia J
5Kemp, Bruce E
6Neal, Bruce C
7Patel, Anushka
8MacMahon, Stephen W
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titlePrediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects With Cerebrovascular Disease
authorCampbell, Duncan J ; Woodward, Mark ; Chalmers, John P ; Colman, Samuel A ; Jenkins, Alicia J ; Kemp, Bruce E ; Neal, Bruce C ; Patel, Anushka ; MacMahon, Stephen W
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1Angiotensin-Converting Enzyme Inhibitors - therapeutic use
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3Arterial hypertension. Arterial hypotension
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5Biomarkers
6Blood and lymphatic vessels
7C-Reactive Protein - analysis
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9Cardiotonic agents
10Cardiovascular system
11Case-Control Studies
12Cerebrovascular Disorders - blood
13Cerebrovascular Disorders - epidemiology
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17Heart Failure - blood
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29Nerve Tissue Proteins - blood
30Peptide Fragments - blood
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32Pharmacology. Drug treatments
33Predictive Value of Tests
34Prognosis
35Prospective Studies
36Randomized Controlled Trials as Topic
37Risk Factors
38Sensitivity and Specificity
39Stroke - blood
40Stroke - epidemiology
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1Woodward, Mark
2Chalmers, John P
3Colman, Samuel A
4Jenkins, Alicia J
5Kemp, Bruce E
6Neal, Bruce C
7Patel, Anushka
8MacMahon, Stephen W
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8MacMahon, Stephen W
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jtitleHypertension
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abstractB-type natriuretic peptide (BNP) and C-reactive protein (CRP) are elevated in persons at risk for congestive heart failure (CHF). However, limited data are available directly comparing BNP-related peptides and CRP in persons at risk of CHF. To evaluate amino terminal–pro-BNP (NT-proBNP) and CRP, separately and together, for assessment of risk of CHF, we performed a nested case-control study of the 6105 participants of the Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS), a placebo-controlled study of a perindopril-based blood pressure–lowering regimen among individuals with previous stroke or transient ischemic attack (TIA). Each of 258 subjects who developed CHF resulting in death, hospitalization, or withdrawal of randomized therapy during a mean follow-up of 3.9 years was matched to 1 to 3 control subjects. NT-proBNP and CRP predicted CHF; the odds ratio for subjects in the highest compared with the lowest quarter was 4.5 (95% confidence interval, 2.7 to 7.5) for NT-proBNP and 2.9 (confidence interval, 1.9 to 4.7) for CRP, and each remained a predictor of CHF after adjustment for all other predictors. Screening for both markers provided better prognostic information than screening for either alone. Elevation of NT-proBNP above 50 pmol/L and CRP above 0.84 mg/L predicted CHF with sensitivity of 64% and specificity of 66%. NT-proBNP and CRP predicted CHF in subjects receiving perindopril-based therapy. We conclude that NT-proBNP and CRP are independent predictors of CHF risk after stroke or TIA. Moreover, NT-proBNP and CRP may be markers of mechanisms of CHF pathogenesis distinct from those responsive to angiotensin-converting enzyme inhibitor–based therapy.
cop
0Philadelphia, PA
1Hagerstown, MD
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pmid15569851
doi10.1161/01.HYP.0000151103.02424.c3
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