title: Midregional pro-atrial natriuretic peptide in the general population/Insights from the Gutenberg Health Study.
abstract: BACKGROUND
  The use of biomarkers is firmly established for the assessment of cardiovascular disease. Emerging biomarkers such as midregional pro-atrial natriuretic peptide (MR-proANP) challenge established markers regarding risk prediction and stratification ability. The aim of the present study was to describe the distribution of a contemporary MR-proANP assay in a large population-representative sample and to evaluate the association with prevalent cardiac diseases and cardiovascular risk factors.
  
  
  METHODS
  MR-proANP was determined by the use of a contemporary commercially available assay (BRAHMS GmbH, Hennigsdorf, Germany) in a representative sample of 5000 participants from the large population-based Gutenberg Health Study. N-terminal pro B-type natriuretic peptide (NT-proBNP) was used as a comparator.
  
  
  RESULTS
  Mean age was 55.5 ± 10.9 years. Coronary artery disease (CAD) was documented in 4.6%, heart failure (HF) in 1.5% of the study participants. We observed a moderate to strong correlation of the biomarkers with age, diabetes, hypertension, smoking, renal function, prevalence of CAD and HF. Males showed lower MR-proANP concentrations than females. MR-proANP showed no relevant correlation with BMI (ρ=-0.030) and CRP (ρ=0.039). Reference limits for MR-proANP representing the 95th/97.5th/99th percentile were determined for healthy individuals with 116/132/169 pmol/mL.
  
  
  CONCLUSIONS
  The current analysis in a large population-based sample elucidates the correlations and distribution of MR-proANP. Its concentration in healthy individuals depends on prevalent cardiovascular diseases and classical risk factors. The reported population-based reference values might be useful for distinguishing between healthy and diseased individuals, thus improving risk stratification and triaging in various clinical settings.
authors.affiliation: Department of Medicine 2, University Medical Center Mainz, Langenbeckstrasse 1, 55131 Mainz, Germany. tzikas@gmail.com
authors.forename: Stergios
authors.initials: S
authors.lastname: Tzikas
authors.forename: Till
authors.initials: T
authors.lastname: Keller
authors.forename: Philipp S
authors.initials: PS
authors.lastname: Wild
authors.forename: Andreas
authors.initials: A
authors.lastname: Schulz
authors.forename: Isabella
authors.initials: I
authors.lastname: Zwiener
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.forename: Renate B
authors.initials: RB
authors.lastname: Schnabel
authors.forename: Christoph
authors.initials: C
authors.lastname: Sinning
authors.forename: Edith
authors.initials: E
authors.lastname: Lubos
authors.forename: Jan
authors.initials: J
authors.lastname: Kunde
authors.forename: Thomas
authors.initials: T
authors.lastname: Münzel
authors.forename: Karl J
authors.initials: KJ
authors.lastname: Lackner
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
mesh_terms: D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D009320:Atrial Natriuretic Factor