Usefulness of serial N-terminal pro-B-type natriuretic peptide measurements for determining prognosis in patients with pulmonary arterial hypertension.

Previous studies have shown the prognostic benefit of N-terminal pro-brain natriuretic peptide (NT-pro-BNP) in pulmonary arterial hypertension (PAH) at time of diagnosis. However, there are only limited data on the clinical utility of serial measurements of the inactive peptide NT-pro-BNP in PAH. This study examined the value of serial NT-pro-BNP measurements in predicting prognosis PAH. We retrospectively analyzed all available NT-pro-BNP plasma samples in 198 patients who were diagnosed with World Health Organization group I PAH from January 2002 through January 2009. At time of diagnosis median NT-pro-BNP levels were significantly different between survivors (610 pg/ml, range 6 to 8,714) and nonsurvivors (2,609 pg/ml, range 28 to 9,828, p <0.001). In addition, NT-pro-BNP was significantly associated (p <0.001) with other parameters of disease severity (6-minute walking distance, functional class). Receiver operating curve analysis identified ≥1,256 pg/ml as the optimal NT-pro-BNP cutoff for predicting mortality at time of diagnosis. Serial measurements allowed calculation of baseline NT-pro-BNP (i.e., intercept obtained by back-extrapolation of concentration-time graph), providing a better discrimination between survivors and nonsurvivors than NT-pro-BNP at time of diagnosis alone (p = 0.010). Furthermore, a decrease of NT-pro-BNP of >15%/year was associated with survival. In conclusion, a serum NT-pro-BNP level ≥1,256 pg/ml at time of diagnosis identifies poor outcome in patients with PAH. In addition, a decrease in NT-pro-BNP of >15%/year is associated with survival in PAH.

Mauritz GJ ，Rizopoulos D ，Groepenhoff H ，Tiede H ，Felix J ，Eilers P ，Bosboom J ，Postmus PE ，Westerhof N ，Vonk-Noordegraaf A ... -  《-》

N-terminal pro-B-type natriuretic peptide as an indicator of disease severity in a heterogeneous group of patients with chronic precapillary pulmonary hypertension.

Andreassen AK ，Wergeland R ，Simonsen S ，Geiran O ，Guevara C ，Ueland T ... -  《AMERICAN JOURNAL OF CARDIOLOGY》

N-terminal pro-B-type natriuretic peptide is an independent predictor of outcome in an unselected cohort of critically ill patients.

Meyer B ，Huelsmann M ，Wexberg P ，Delle Karth G ，Berger R ，Moertl D ，Szekeres T ，Pacher R ，Heinz G ... -  《CRITICAL CARE MEDICINE》

Prognostic importance of increased plasma amino-terminal pro-brain natriuretic peptide levels in a large noncardiac, general intensive care unit population.

Kotanidou A ，Karsaliakos P ，Tzanela M ，Mavrou I ，Kopterides P ，Papadomichelakis E ，Theodorakopoulou M ，Botoula E ，Tsangaris I ，Lignos M ，Ikonomidis I ，Ilias I ，Armaganidis A ，Orfanos SE ，Dimopoulou I ... -  《-》

Association of plasma N-terminal pro-B-type natriuretic peptide with postoperative cardiac events in patients undergoing surgery for abdominal aortic aneurysm or leg bypass.

Feringa HH ，Bax JJ ，Elhendy A ，de Jonge R ，Lindemans J ，Schouten O ，van den Meiracker AH ，Boersma E ，Schinkel AF ，Kertai MD ，van Sambeek MR ，Poldermans D ... -  《AMERICAN JOURNAL OF CARDIOLOGY》