Comparative evaluation of B-type natriuretic peptide and mid-regional pro-A-type natriuretic peptide changes from admission to discharge in prognosis of acute decompensated heart failure patients.
BACKGROUND
Mid-regional pro-A-type natriuretic peptide (MRproANP) seems to be non-inferior compared to B-type natriuretic peptide (BNP) for heart failure diagnosis and prognosis; however, no previous studies have investigated the MRproANP in-hospital changes in prognostic role. This study aimed to compare the prognostic accuracy of BNP and MRproANP in-hospital changes in acute decompensated heart failure (ADHF) patients.


METHODS
37 patients with either admission/pre-discharge BNP and MRproANP data, were investigated. The combined endpoint was cardiovascular death/heart transplantation/readmission for HF.


RESULTS
BNP and MRproANP had a median decrease of 55% [72;45] and 21% [40; 11] respectively in event-free patients; BNP decrease of 34% [48; 29] but MRproANP increase of 4% [-7; 25] in patients with cardiovascular events. Prognostic accuracy of deltaBNP and deltaMRproANP was similar.


CONCLUSIONS
MRproANP basically trends up in patients with worse outcome and decreases in event-free patients, likely leading to a simpler interpretation although the prognostic accuracy is similar for both peptides.
Department of Laboratory Medicine, A.O.U, Ospedali Riuniti di Trieste, Trieste, Italy. elisabetta.stenner@libero.it
Elisabetta
E
Stenner
Alessandra
A
Buiatti
Giulia
G
Barbati
Marco
M
Merlo
Gianfranco
G
Sinagra
Bruno
B
Biasioli
D000208:Acute Disease; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010351:Patient Discharge / Q000706:statistics & numerical data; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results
D015415:Biomarkers; C472955:NPPA protein, human; D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor