title: Probrain natriuretic peptide for assessment of efficacy in heart failure treatment.
abstract: N-terminal probrain natriuretic peptide (NT-proBNP) is elevated in patients with heart failure. Numerous clinical trials have evaluated the efficacy of spironolactone in heart failure; however, no studies have directly examined the effects of spironolactone treatment on NT-proBNP level. This study investigated whether NT-proBNP levels decrease with daily spironolactone treatment. The study consisted of 117 adult patients with heart failure. All participants were divided into 3 groups, class I, class II, and class III, according to the New York Heart Association classification system. Patients were randomly assigned to receive spironolactone or were treated with another drug, other than spironolactone, as placebo. NT-proBNP plasma samples were taken at baseline and after 6 mo of treatment. A total of 62 patients were treated with daily spironolactone; 55 patients were followed with available treatment without spironolactone. The baseline demographic and laboratory parameters were similar for patients in all groups. At the end of 6 mo, spironolactone-treated patients had significantly lower NT-proBNP levels and significantly better ejection fractions than did patients in all New York Heart Association classes who were not treated with spironolactone. Results suggest that spironolactone decreases plasma NT-proBNP concentrations, and that the measurement of plasma NT-proBNP levels may be helpful in assessing therapeutic efficacy in patients who are treated for heart failure.
authors.affiliation: Department of Family Medicine, Fatih University, School of Medicine, Ankara, Turkey.
authors.forename: Adem
authors.initials: A
authors.lastname: Ozkara
authors.forename: Faruk
authors.initials: F
authors.lastname: Turgut
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Selcoki
authors.forename: Aydin
authors.initials: A
authors.lastname: Karanfil
authors.forename: Melike Rusen
authors.initials: MR
authors.lastname: Metin
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kanbay
authors.forename: Oguz
authors.initials: O
authors.lastname: Tekin
authors.forename: Ali
authors.initials: A
authors.lastname: Akcay
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy* / Q000503:physiopathology; D006801:Humans; D008297:Male; D000451:Mineralocorticoid Receptor Antagonists; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D013148:Spironolactone / Q000627:therapeutic use*; D013318:Stroke Volume
chemical_list: D015415:Biomarkers; D000451:Mineralocorticoid Receptor Antagonists; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D013148:Spironolactone