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Clerico A, Zaninotto M, Aimo A, Musetti V, Perrone M, Padoan A, Dittadi R, Sandri MT, Bernardini S, Sciacovelli L, Trenti T, Malloggi L, Moretti M, Burgio MA, Manno ML, Migliardi M, Fortunato A, Plebani M. Evaluation of the cardiovascular risk in patients undergoing major non-cardiac surgery: role of cardiac-specific biomarkers. A consensus document by the Inter-Society Study Group on Cardiac Biomarkers of the Italian Societies of Clinical Biochemistry: European Ligand Assay Society (ELAS), Italian section; Società Italiana di Biochimica Clinica e Biologia Molecolare Clinica (SIBioC); Società Italiana di Patologia Clinica e Medicina di Laboratorio (SIPMel). Clin Chem Lab Med 2022; 60:1525-1542. [PMID: 35858238 DOI: 10.1515/cclm-2022-0481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 07/05/2022] [Indexed: 11/15/2022]
Abstract
Major adverse cardiovascular events are frequently observed in patients undergoing major non-cardiac surgery during the peri-operative period. At this time, the possibility to predict cardiovascular events remains limited, despite the introduction of several algorithms to calculate the risk of adverse events, mainly death and major adverse cardiovascular events (MACE) based on the clinical history, risk factors (sex, age, lipid profile, serum creatinine) and non-invasive cardiac exams (electrocardiogram, echocardiogram, stress tests). The cardiac-specific biomarkers natriuretic peptides (NPs) and cardiac troponins (cTn) have been proposed as additional tools for risk prediction in the peri-operative period, particularly for the identification of myocardial injury in patients undergoing major non-cardiac surgery. The prognostic information from the measurement of BNP/NT-proBNP and hs-cTn is independent and complementary to other important indicators of risk, also including ECG and imaging techniques. Elevated levels of cardiac-specific biomarkers before surgery are associated with a markedly higher risk of MACE during the peri-operative period. BNP/NT-proBNP and hs-cTn should be measured in all patients during the clinical evaluation before surgery, particularly during intermediate- or high-risk surgery, in patients aged >65 years and/or with comorbidities. Several questions remain to be assessed in dedicated clinical studies, such as how to optimize the management of patients with raised cardiac specific biomarkers before surgery, and whether a strategy based on biomarker measurement improves patient outcomes and is cost-effective.
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Affiliation(s)
- Aldo Clerico
- Scuola Superiore Sant'Anna e Fondazione CNR-Regione Toscana G. Monasterio, Pisa, Italy
| | - Martina Zaninotto
- Dipartimento di Medicina di Laboratorio, Università-Ospedale di Padova e Azienda Ospedaliera Universitaria di Padova, e Dipartimento di Medicina-Università di Padova, Padova, Italy
| | - Alberto Aimo
- Scuola Superiore Sant'Anna e Fondazione CNR-Regione Toscana G. Monasterio, Pisa, Italy
| | - Veronica Musetti
- Scuola Superiore Sant'Anna e Fondazione CNR-Regione Toscana G. Monasterio, Pisa, Italy
| | - Marco Perrone
- Dipartimento di Medicina Sperimentale, Università di Roma Tor Vergata, Roma, Italy
| | - Andrea Padoan
- Dipartimento di Medicina di Laboratorio, Università-Ospedale di Padova e Azienda Ospedaliera Universitaria di Padova, e Dipartimento di Medicina-Università di Padova, Padova, Italy
| | | | | | - Sergio Bernardini
- Dipartimento di Medicina Sperimentale, Università di Roma Tor Vergata, Roma, Italy
| | - Laura Sciacovelli
- Dipartimento di Medicina di Laboratorio, Università-Ospedale di Padova e Azienda Ospedaliera Universitaria di Padova, e Dipartimento di Medicina-Università di Padova, Padova, Italy
| | - Tommaso Trenti
- Dipartimento di Medicina di Laboratorio e Anatomia Patologica, Azienda Ospedaliera Universitaria e USL di Modena, Modena, Italy
| | - Lucia Malloggi
- Laboratorio Analisi, Azienda Ospedaliera-Universitaria di Pisa, Pisa, Italy
| | - Marco Moretti
- Medicina di Laboratorio, AOU Ospedali Riuniti Ancona, Ancona, Italy
| | | | | | - Marco Migliardi
- Laboratorio Analisi, Ospedale Ordine Mauriziano, Torino, Italy
| | | | - Mario Plebani
- Dipartimento di Medicina di Laboratorio-DIMED, Università di Padova, Padova, Italy
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2
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Natriuretic Peptides and Troponins to Predict Cardiovascular Events in Patients Undergoing Major Non-Cardiac Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095182. [PMID: 35564577 PMCID: PMC9103429 DOI: 10.3390/ijerph19095182] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 04/17/2022] [Accepted: 04/19/2022] [Indexed: 02/01/2023]
Abstract
Patients undergoing major surgery have a substantial risk of cardiovascular events during the perioperative period. Despite the introduction of several risk scores based on medical history, classical risk factors and non-invasive cardiac tests, the possibility of predicting cardiovascular events in patients undergoing non-cardiac surgery remains limited. The cardiac-specific biomarkers, natriuretic peptides (NPs) and cardiac troponins (cTn) have been proposed as additional tools for risk prediction in the perioperative period. This review paper aims to discuss the value of preoperative levels and perioperative changes in cardiac-specific biomarkers to predict adverse outcomes in patients undergoing major non-cardiac surgery. Based on several prospective observational studies and six meta-analyses, some guidelines recommended the measurement of NPs to refine perioperative cardiac risk estimation in patients undergoing non-cardiac surgery. More recently, several studies reported a higher mortality in surgical patients presenting an elevation in high-sensitivity cardiac troponin T and I, especially in elderly patients or those with comorbidities. This evidence should be considered in future international guidelines on the evaluation of perioperative risk in patients undergoing major non-cardiac surgery.
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3
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Rimmele DL, Borof K, Jensen M, Behrendt CA, Cheng B, Debus ES, Gerloff C, Thomalla G. Association Between Carotid Atherosclerosis and Atrial Fibrillation, Cardiac, and Renal Function. Eur J Vasc Endovasc Surg 2022; 63:641-647. [DOI: 10.1016/j.ejvs.2022.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 11/03/2022]
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Lind L, Gigante B, Borné Y, Feldreich T, Leppert J, Hedberg P, Östgren CJ, Nyström FH, Sundström J, Ärnlöv J, Baldassarre D, Tremoli E, Veglia F, Hamsten A, O'Donnell CJ, Franceschini N, Orho-Melander M, Nilsson J, Melander O, Engström G, Mälarstig A. Plasma Protein Profile of Carotid Artery Atherosclerosis and Atherosclerotic Outcomes: Meta-Analyses and Mendelian Randomization Analyses. Arterioscler Thromb Vasc Biol 2021; 41:1777-1788. [PMID: 33657885 DOI: 10.1161/atvbaha.120.315597] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Lars Lind
- Department of Medical Sciences, Uppsala University, Sweden (L.L., J.S.)
| | - Bruna Gigante
- Unit of Cardiovascular Medicine, Department of Medicine, Karolinska Institutet, Sweden (B.G., A.H., A.M.)
| | - Yan Borné
- Department of Clinical Sciences Malmö, Lund University, Sweden (Y.B., M.O.-M., J.N., O.M., G.E.)
| | - Tobias Feldreich
- School of Health and Social Sciences, Dalarna University, Falun, Sweden (T.F., J.A.)
| | - Jerzy Leppert
- Centre for Clinical Research, Uppsala University (J.L., P.H.), Västmanland County Hospital, Västerås, Sweden
| | - Pär Hedberg
- Centre for Clinical Research, Uppsala University (J.L., P.H.), Västmanland County Hospital, Västerås, Sweden.,Department of Clinical Physiology (P.H.), Västmanland County Hospital, Västerås, Sweden
| | - Carl Johan Östgren
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden (C.J.O., F.H.N.).,Department of Medicine, Boston University, MA (C.J.O.)
| | - Fredrik H Nyström
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden (C.J.O., F.H.N.)
| | - Johan Sundström
- Department of Medical Sciences, Uppsala University, Sweden (L.L., J.S.).,The George Institute for Global Health, University of New South Wales, Sydney, Australia (J.S.)
| | - Johan Ärnlöv
- School of Health and Social Sciences, Dalarna University, Falun, Sweden (T.F., J.A.)
| | - Damiano Baldassarre
- Damiano Baldassarre, Department of Medical Biotechnology and Translational Medicine, Università di Milano (D.B.).,Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., E.T., F.V.)
| | - Elena Tremoli
- Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., E.T., F.V.)
| | - Fabrizio Veglia
- Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., E.T., F.V.)
| | - Anders Hamsten
- Unit of Cardiovascular Medicine, Department of Medicine, Karolinska Institutet, Sweden (B.G., A.H., A.M.)
| | - Christopher J O'Donnell
- Department of Health, Medicine and Caring Sciences, Linköping University, Sweden (C.J.O., F.H.N.).,Department of Medicine, Boston University, MA (C.J.O.)
| | - Nora Franceschini
- Department of Epidemiology, University of North Caroline, Capel Hill (N.F.)
| | - Marju Orho-Melander
- Department of Clinical Sciences Malmö, Lund University, Sweden (Y.B., M.O.-M., J.N., O.M., G.E.)
| | - Jan Nilsson
- Department of Clinical Sciences Malmö, Lund University, Sweden (Y.B., M.O.-M., J.N., O.M., G.E.)
| | - Olle Melander
- Department of Clinical Sciences Malmö, Lund University, Sweden (Y.B., M.O.-M., J.N., O.M., G.E.)
| | - Gunnar Engström
- Department of Clinical Sciences Malmö, Lund University, Sweden (Y.B., M.O.-M., J.N., O.M., G.E.)
| | - Anders Mälarstig
- Unit of Cardiovascular Medicine, Department of Medicine, Karolinska Institutet, Sweden (B.G., A.H., A.M.)
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5
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Rahmani R, Shafiee A, Parazaran K, Reshadati N. Predictive value of N-terminal-Pro brain natriuretic peptide in the detection of coronary artery disease in patients with positive myocardial perfusion imaging. Med J Islam Repub Iran 2019; 33:14. [PMID: 31086793 PMCID: PMC6504941 DOI: 10.34171/mjiri.33.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Indexed: 01/22/2023] Open
Abstract
Background: N-terminal pro-brain natriuretic peptide (NT-ProBNP) increases during myocardial ischemia and has a potential for the diagnosis of patients with coronary artery disease (CAD). We aimed to determine the incremental diagnostic value of NT-ProBNP in the selection of patients with positive myocardial perfusion imaging (MPI) for coronary angiography. We also tested the association between the level of NT-ProBNP and severity of CAD based on the vessel score and Gensini score.
Methods: In this cross-sectional study, stable angina patients with positive MPI who were assessed by coronary angiography in Imam Khomeini Hospitalwere enrolled. After the collection of demographic and clinical data, NT-ProBNP was measured in all patients on the day of coronary angiography, and its association with the presence of CAD, vessel score and Gensini score was tested.
Results: We enrolled 170 patients (mean age61.2±10.1 years, 86 males (50.6%)). Seventy-two (42.3%) patients had at least one stenotic vessel. NT-Pro BNP was significantly higher in the CAD-positive group (OR=1.01, 95% CI: 1.00-1.02; p=0.008) and could independently predict the presence of CAD at a cut-off point of 69.5, with a sensitivity of 55.6%, specificity of 82.5% and diagnostic accuracy of 61.7%. The Gensini score had a modest correlation with NT-Pro BNP (r=0.60, p<0.001). The combination of MPI result and NT-Pro BNP could predict the presence of CAD (OR=14.57, 95% CI: 4.28, 49.56; p<0.001).
Conclusion: Serum level of NT-Pro BNP alone and its combination with the results of MPI can significantly predict the presence of CAD and therefore, highlights the need for performing coronary angiography.
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Affiliation(s)
- Reza Rahmani
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Shafiee
- Department of Cardiovascular Research, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Kambiz Parazaran
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Najmeh Reshadati
- Department of Cardiology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Satoh M, Murakami T, Asayama K, Hirose T, Kikuya M, Inoue R, Tsubota-Utsugi M, Murakami K, Matsuda A, Hara A, Obara T, Kawasaki R, Nomura K, Metoki H, Node K, Imai Y, Ohkubo T. N-Terminal Pro-B-Type Natriuretic Peptide Is Not a Significant Predictor of Stroke Incidence After 5 Years - The Ohasama Study. Circ J 2018; 82:2055-2062. [PMID: 29887544 DOI: 10.1253/circj.cj-17-1227] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point.Methods and Results:We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0-54.9-pg/mL, 55.0-124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94-3.94), 1.77 (0.85-3.66), and 1.99 (0.86-4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03-19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. CONCLUSIONS NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.
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Affiliation(s)
- Michihiro Satoh
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Takahisa Murakami
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University.,Division of Aging and Geriatric Dentistry, Department of Oral Function and Morphology, Tohoku University Graduate School of Dentistry
| | - Kei Asayama
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Tohoku Institute for Management of Blood Pressure
| | - Takuo Hirose
- Division of Nephrology and Endocrinology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University
| | - Masahiro Kikuya
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University
| | - Ryusuke Inoue
- Department of Medical Information Technology Center, Tohoku University Hospital
| | - Megumi Tsubota-Utsugi
- Department of Hygiene and Preventive Medicine, Iwate Medical University School of Medicine
| | - Keiko Murakami
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Ayako Matsuda
- Department of Hygiene and Public Health, Teikyo University School of Medicine
| | - Azusa Hara
- Department of Social Pharmacy and Public Health, Showa Pharmaceutical University
| | - Taku Obara
- Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University.,Department of Pharmaceutical Sciences, Tohoku University Hospital
| | - Ryo Kawasaki
- Department of Vision Informatics (Topcon), Osaka University Graduate School of Medicine.,Department of Public Health, Yamagata University Graduate School of Medical Science
| | - Kyoko Nomura
- Department of Public Health, Akita University Graduate School of Medicine
| | - Hirohito Metoki
- Division of Public Health, Hygiene and Epidemiology, Faculty of Medicine, Tohoku Medical and Pharmaceutical University.,Tohoku Institute for Management of Blood Pressure.,Department of Community Medical Supports, Tohoku Medical Megabank Organization, Tohoku University
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University
| | - Yutaka Imai
- Tohoku Institute for Management of Blood Pressure
| | - Takayoshi Ohkubo
- Department of Hygiene and Public Health, Teikyo University School of Medicine.,Tohoku Institute for Management of Blood Pressure
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7
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Sterling MR, Durant RW, Bryan J, Levitan EB, Brown TM, Khodneva Y, Glasser SP, Richman JS, Howard G, Cushman M, Safford MM. N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study. BMC Cardiovasc Disord 2018; 18:66. [PMID: 29661151 PMCID: PMC5902876 DOI: 10.1186/s12872-018-0806-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 04/11/2018] [Indexed: 01/28/2023] Open
Abstract
Background N-terminal pro B-type peptide (NT-proBNP) has been associated with risk of myocardial infarction (MI), but less is known about the relationship between NT-proBNP and very small non ST-elevation MI, also known as microsize MI. These events are now routinely detectable with modern troponin assays and are emerging as a large proportion of all MI. Here, we sought to compare the association of NT-proBNP with risk of incident typical MI and microsize MI in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Methods The REGARDS Study is a national cohort of 30,239 US community-dwelling black and white adults aged ≥ 45 years recruited from 2003 to 2007. Expert-adjudicated outcomes included incident typical MI (definite/probable MI with peak troponin ≥ 0.5 μg/L), incident microsize MI (definite/probable MI with peak troponin < 0.5 μg/L), and incident fatal CHD. Using a case-cohort design, we estimated the hazard ratio of the outcomes as a function of baseline NT-proBNP. Competing risk analyses tested whether the associations of NT-proBNP differed between the risk of incident microsize MI and incident typical MI as well as if the association of NT-proBNP differed between incident non-fatal microsize MI and incident non-fatal typical MI, while accounting for incident fatal coronary heart disease (CHD) as well as heart failure (HF). Results Over a median of 5 years of follow-up, there were 315 typical MI, 139 microsize MI, and 195 incident fatal CHD. NT-proBNP was independently and strongly associated with all CHD endpoints, with significantly greater risk observed for incident microsize MI, even after removing individuals with suspected HF prior to or coincident with their incident CHD event. Conclusion NT-proBNP is associated with all MIs, but is a more powerful risk factor for microsize than typical MI. Electronic supplementary material The online version of this article (10.1186/s12872-018-0806-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Madeline R Sterling
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, P.O. Box 46, New York, N.Y 10065, USA.
| | - Raegan W Durant
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Joanna Bryan
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, P.O. Box 46, New York, N.Y 10065, USA
| | - Emily B Levitan
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Todd M Brown
- Division of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Yulia Khodneva
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - Stephen P Glasser
- Department of Internal Medicine, University of Kentucky College of Medicine, Louisville, KY, USA
| | - Joshua S Richman
- Department of Surgery, University of Alabama at Birmingham School of Medicine, Birmingham, AL, USA
| | - George Howard
- Department of Biostatistics, University of Alabama at Birmingham School of Public Health, Birmingham, AL, USA
| | - Mary Cushman
- Departments of Medicine and Pathology, Larner College of Medicine at the University of Vermont, Burlington, VT, USA
| | - Monika M Safford
- Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical College, 1300 York Avenue, P.O. Box 46, New York, N.Y 10065, USA
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8
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Emdin M, Aimo A, Vergaro G, Pastormerlo LE, Clerico A. Natriuretic peptides. D'où venons-nous? Que sommes-nous? Où allons-nous? Int J Cardiol 2018; 254:256-257. [PMID: 29407104 DOI: 10.1016/j.ijcard.2017.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2017] [Accepted: 12/11/2017] [Indexed: 12/11/2022]
Affiliation(s)
- Michele Emdin
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy.
| | - Alberto Aimo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy
| | | | - Luigi Emilio Pastormerlo
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy
| | - Aldo Clerico
- Institute of Life Sciences, Scuola Superiore Sant'Anna, Pisa, Italy; Fondazione Toscana Gabriele Monasterio, Pisa, Italy
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9
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Pastormerlo LE, Maffei S, Latta DD, Chubuchny V, Susini C, Berti S, Prontera C, Storti S, Passino C, Pasanisi E, Emdin M, Chiappino D. N-terminal fragment of B-type natriuretic peptide predicts coexisting subclinical heart and vessel disease. J Cardiovasc Med (Hagerstown) 2017; 18:750-757. [DOI: 10.2459/jcm.0000000000000514] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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10
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Roever L, Resende ES, Roerver-Borges AS. Impact of pro-atrial natriuretic peptide in atrial fibrillation and stroke. Eur J Prev Cardiol 2017; 24:1239-1241. [PMID: 28452559 DOI: 10.1177/2047487317707832] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Leonardo Roever
- 1 Federal University of Uberlândia, Department of Clinical Research, Uberlândia, Brazil
| | - Elmiro Santos Resende
- 1 Federal University of Uberlândia, Department of Clinical Research, Uberlândia, Brazil
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11
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Berntsson J, Smith JG, Nilsson PM, Hedblad B, Melander O, Engström G. Pro-atrial natriuretic peptide and prediction of atrial fibrillation and stroke: The Malmö Preventive Project. Eur J Prev Cardiol 2017; 24:788-795. [DOI: 10.1177/2047487317693948] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- John Berntsson
- Department of Clinical Sciences, Lund University, Sweden
| | - J Gustav Smith
- Department of Cardiology, Lund University, Sweden
- Department of Heart Failure and Valvular Disease, Skåne University Hospital, Sweden
- Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, USA
| | | | - Bo Hedblad
- Department of Clinical Sciences, Lund University, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Sweden
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12
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Wei XB, Liu YH, He PC, Yu DQ, Zhou YL, Tan N, Chen JY. Prognostic value of N-terminal prohormone brain natriuretic peptide for in-hospital and long-term outcomes in patients with infective endocarditis. Eur J Prev Cardiol 2017; 24:676-684. [PMID: 28067531 DOI: 10.1177/2047487316686436] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Xue-biao Wei
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangdong, China
| | - Yuan-hui Liu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangdong, China
| | - Peng-cheng He
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangdong, China
| | - Dan-qing Yu
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangdong, China
| | - Ying-ling Zhou
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangdong, China
| | - Ning Tan
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangdong, China
| | - Ji-yan Chen
- Department of Cardiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of Coronary Heart Disease Prevention, Guangdong General Hospital, Guangdong Academic of Medical Sciences, Guangdong, China
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13
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Dietl A, Stark K, Zimmermann ME, Meisinger C, Schunkert H, Birner C, Maier LS, Peters A, Heid IM, Luchner A. NT-proBNP Predicts Cardiovascular Death in the General Population Independent of Left Ventricular Mass and Function: Insights from a Large Population-Based Study with Long-Term Follow-Up. PLoS One 2016; 11:e0164060. [PMID: 27711172 PMCID: PMC5053441 DOI: 10.1371/journal.pone.0164060] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 09/19/2016] [Indexed: 12/28/2022] Open
Abstract
Aims B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) predict cardiovascular endpoints in patients and all-cause death in the general population. This was assigned to their association with clinical cardiac remodelling defined as changes in size, shape and function of the heart. The aim of this study was to evaluate whether NT-proBNP and BNP were associated with cardiovascular and overall death independent of clinical cardiac remodelling measured by echocardiography as left ventricular hypertrophy (LVH), diastolic dysfunction and left ventricular ejection fraction (EF). Methods and Results In a general population-based cohort study from Germany (KORA-S3) with subjects’ baseline age ranging from 25 to 74 years, cardiac morphology and function were assessed as left ventricular mass (LVM), diastolic dysfunction and EF by echocardiography and circulating NT-proBNP and BNP were measured at baseline. In 1,223 subjects with mortality follow-up information, we examined the association of baseline NT-proBNP and BNP with cardiovascular mortality (number of deaths = 52, median follow-up time = 12.9years) using Cox regression without and with adjustment for cardiovascular risk factors, LVM, diastolic dysfunction and EF. The risk of cardiovascular mortality increased with higher NT-proBNP levels measured at baseline (hazard ratio HR = 1.67 per unit increment in logNT-proBNP, p = 2.78*10−4, adjusted for age and sex). This increased risk persisted after adjustment for cardiovascular risk factors, LVM, diastolic dysfunction and EF (HR = 1.73; p = 0.047). When excluding subjects with relevant LVH (LVM to body surface area > 149g/m2 in men / 122g/m2 in women), the NT-proBNP association with mortality was still significant (n = 1,138; number of deaths = 35; HR = 1.48; p = 0.04). We found similar results for BNP. Conclusion Our data confirms NT-proBNP and BNP as predictor of cardiovascular mortality in a large general population-based study with long-term follow-up. Our study extends previously published population-based studies to younger and potentially healthier individuals without relevant LVH, diastolic dysfunction or LVD.
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Affiliation(s)
- Alexander Dietl
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Klaus Stark
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
| | | | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz Zentrum Muenchen, German Research Centre for Environmental Health, Neuherberg, Germany
| | - Heribert Schunkert
- Deutsches Herzzentrum Muenchen, Technische Universitaet Muenchen, and DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
| | - Christoph Birner
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Lars S. Maier
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz Zentrum Muenchen, German Research Centre for Environmental Health, Neuherberg, Germany
| | - Iris M. Heid
- Department of Genetic Epidemiology, University of Regensburg, Regensburg, Germany
- * E-mail:
| | - Andreas Luchner
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
- Klinikum Amberg, Amberg, Germany
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Caselli C, Ragusa R, Prontera C, Cabiati M, Cantinotti M, Federico G, Del Ry S, Trivella MG, Clerico A. Distribution of circulating cardiac biomarkers in healthy children: from birth through adulthood. Biomark Med 2016; 10:357-65. [DOI: 10.2217/bmm-2015-0044] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Aim: While circulating biomarkers are critical tools for cardiovascular adult care, their relevance in childhood is unknown. Methods: We evaluated the behavior of plasma concentrations of clinically relevant cardiac biomarkers (NT-proBNP, hs-cTnI, sST2, Galectin-3) in 106 healthy children. Results: Subjects were divided into age subgroups: 24 newborns (0–30 days), 26 infants (1–12 months), 30 children (1–12 years) and 26 adolescents (13–18 years). Healthy adults were used as control. NT-proBNP (newborns: 504.3 [211.07–942.7] ng/L, median [25–75 percentiles]; infants: 200.64 [76.88–306.73]; children: 97.27 [49.24–271.80]; adolescents: 24.35 [13.14–58.83]; p < 0.001) and hs-cTnI (newborns: 9.3 [3.3–93.8] ng/L; infants: 13.8 [4.82–72.52]; children: 11.45 [4.0–48.10]; adolescents: 2.6[2.07–3.90]; p < 0.001) were highest in the first month of life, showing a decline in the next years. sST2 and Galectin-3 showed no differences. Conclusion: Changes in hs-cTnI and NT-proBNP suggest the design of age- and sex-based reference intervals that will have to be explored in a larger population.
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Affiliation(s)
| | | | | | | | | | - Giovanni Federico
- U.O. Pediatria Universitaria, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
| | | | | | - Aldo Clerico
- Fondazione Toscana G. Monasterio, Pisa and Massa, Italy
- U.O. Pediatria Universitaria, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy
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