title: Urinary B-type natriuretic peptide levels in the diagnosis and prognosis of heart failure.
abstract: BACKGROUND
  Plasma B-type natriuretic peptide (BNP) is a useful biomarker for diagnosis and prognosis of heart failure (HF); however, urine BNP has never been calculated. We sought to compare urinary and plasma BNP levels and to investigate the potential diagnostic and prognostic value of this peptide in HF.
  
  
  RESULTS
  Urine and plasma BNP levels were measured in 92 HF patients and 30 control subjects. Urinary BNP levels were higher in HF patients than in control subjects (P < .0001), correlating with plasma BNP levels (r = 0.64, P < .0001). Urine BNP was a good tool for the diagnosis of HF, the area under the curve (AUC) being 0.91 +/- 0.06 (P < .0001). Urinary BNP levels had prognostic power for cardiac events (cardiac admissions + mortality) with an odds ratio of 6.6 (P < .05). To determine the prognostic power of urinary BNP in detecting 12-month cardiac mortality, we obtained an AUC of 0.76 +/- 0.6 (P = .014).
  
  
  CONCLUSIONS
  The data suggest that urine BNP is a new candidate marker for diagnosis and prognosis of HF mortality and cardiac events. This raises the possibility of using this relatively simple noninvasive test in primary care settings or in specific conditions where the collection of blood samples could be difficult.
authors.affiliation: Cardiology Unit, Research Center, Hospital Universitario La Fe, Valencia, Spain.
authors.forename: Raquel
authors.initials: R
authors.lastname: Cortés
authors.forename: Miguel
authors.initials: M
authors.lastname: Rivera
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvador
authors.forename: Fernando
authors.initials: F
authors.lastname: García de Burgos
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu
authors.forename: Esther
authors.initials: E
authors.lastname: Roselló-Lletí
authors.forename: Luís
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: Rafael
authors.initials: R
authors.lastname: Payá
authors.forename: Luis
authors.initials: L
authors.lastname: Almenar
authors.forename: Manuel
authors.initials: M
authors.lastname: Portolés
mesh_terms: D000368:Aged; D019540:Area Under Curve; D015415:Biomarkers / Q000652:urine; D005260:Female; D006331:Heart Diseases / Q000209:etiology; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000401:mortality / Q000652:urine*; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood / Q000652:urine*; D016017:Odds Ratio; D011379:Prognosis