title: Prospective monitoring N-terminal pro-brain natriuretic peptide during natural progression of atherosclerotic renal artery stenosis in elderly.
abstract: Prognostic values of N-terminal pro-brain natriuretic peptide (NT-proBNP) in myriad diseases have been studied. During the natural progression of atherosclerotic renal artery disease (ARVD) changes of NT-proBNP levels and its significance is not understood. A prospective longitudinal follow-up study was conducted among 61 ARVD patients (77.7 ± 5.2 years old). NT-proBNP was determined at baseline and six month intervals over 25.89 ± 12.44 months and its correlation with death and/or newly occurred CVEs were assessed. Level of NT-proBNP increased from baseline median 210.0 pg/mL (25th-75th percentile, 98.0 pg/mL-540.0 pg/mL) to 900.9 pg/mL (25th-75th percentile, 704.5 pg/mL-1583.5 pg/mL) (p=0.032) at the end of follow-up. Among 44.26% of the cohort (n=27) NT-proBNP level ≥450 pg/mL was detected, which 6 deaths happened (22.22% death rate) and CVEs occurred to 62.96% of patients, comparing to 0% death rate (p=0.077) and 8.82% affected by CVEs (p=0.019) in other 55.74% of cohort (n=34) whose NT-proBNP <450 pg/mL. Kaplan-Meier analysis showed that NT-proBNP level ≥450 pg/mL was a risk factor related to CVEs (HR=3.96, p=0.03). Cox regression analysis found NT-proBNP level ≥450 pg/mL was an independent risk factor of CVEs (HR=5.12, p=0.022) after adjustment of body mass index, blood pressure, kidney function. The negative predictive value was 90.9% of NT-proBNP levels ≥450 pg/mL for new CVEs. NT-proBNP levels diverge throughout ARVD natural progression in elderly males over 75 years of age. Elevated NT-proBNP level of ≥450 pg/mL was predictive for CVEs with 90.9% of negative predictive value.
authors.affiliation: Second Division of Geriatric Cardiology, Chinese PLA General Hospital, Beijing, PR China.
authors.forename: Qiwei
authors.initials: Q
authors.lastname: Zhu
authors.forename: Ningyu
authors.initials: N
authors.lastname: An
authors.forename: Yongyi
authors.initials: Y
authors.lastname: Bai
authors.forename: Ning
authors.initials: N
authors.lastname: Zhu
authors.forename: Meihua
authors.initials: M
authors.lastname: Li
mesh_terms: D000367:Age Factors; D000368:Aged; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D018450:Disease Progression; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods*; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D011498:Protein Precursors; D012078:Renal Artery Obstruction / Q000097:blood* / Q000209:etiology; D012307:Risk Factors; D014463:Ultrasonography
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; D011498:Protein Precursors; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain