N-terminal pro-brain natriuretic peptide predicts cardiovascular events in patients with hypertension and left ventricular hypertrophy: a LIFE study

被引:90
作者
Olsen, MH [1 ]
Wachtell, K
Tuxen, C
Fossum, E
Bang, LE
Hall, C
Ibsen, H
Rokkedal, J
Devereux, RB
Hildebrandt, P
机构
[1] Glostrup Univ Hosp, Dept Clin Physiol & Nucl Med, DK-2600 Glostrup, Denmark
[2] Frederiksberg Univ Hosp, DK-2000 Copenhagen, Denmark
[3] Ullevaal Univ Hosp, Oslo, Norway
[4] Rigshosp, Inst Clin Biochem, Oslo, Norway
[5] Cornell Univ, Weill Med Coll, New York, NY USA
关键词
hypertension; left ventricular hypertrophy; natriuretic peptides; Nt-proBNP; Nt-proANP; cardiovascular risk;
D O I
10.1097/01.hjh.0000125451.28861.2a
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Background N-terminal pro-brain natriuretic peptide (Nt-proBNP) and N-terminal pro-atrial natriuretic peptide (Nt-proANP) are strong cardiovascular risk markers in patients with chronic heart failure, as well as in the general population. We investigated whether high Nt-proBNP or Nt-proANP could also predict the composite endpoint (CEP) of cardiovascular death, non-fatal stroke or non-fatal myocardial infarction in patients with hypertension and left ventricular (LV) hypertrophy. Methods After 2 weeks of placebo treatment, clinical, laboratory and echocardiographic variables were assessed in 183 hypertensive participants in the LIFE echo substudy with electrocardiographic LV hypertrophy. Nt-proBNP and Nt-proANP were measured by immunoassay at baseline. The patients were followed for 60 5 months. Results Using Cox regression analysis, the 25 CEP were predicted by ln(Nt-proBNP) (hazard ratio 1.61 per 2.73-fold increase, P < 0.01) as well as In(Nt-proANP) (hazard ratio 2.93, P< 0.05). Nt-proBNP above the median value of 21.8 pmol/ml was associated with higher incidence of CEP (19.6 versus 7.7%, P < 0.05). Nt-proBNP above the median value was associated with higher incidence of CEP in the 123 patients without history of diabetes or cardiovascular disease (14.8 versus 4.3%, P < 0.05), but the association was insignificant in the 60 patients with a history of diabetes or cardiovascular disease (26.3 versus 18.2%, NS). Nt-proANP showed the same tendency. Conclusion Nt-proBNP, more than Nt-proANP, strongly predicts cardiovascular events in patients with hypertension and LV hypertrophy, especially in patients without diabetes or clinically overt cardiovascular disease.
引用
收藏
页码:1597 / 1604
页数:8
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