title: Mid-regional pro-atrial natriuretic peptide levels in the elderly: clinical and prognostic implications, and comparison to B-type natriuretic peptides.
abstract: BACKGROUND
  Mid-regional pro-atrial natriuretic peptide (MR-proANP) is emerging as an indicator of cardiac abnormalities and adverse outcome in heart failure patients. However, there are only sparse data on its clinical value relative to the B-type natriuretic peptides in the general population.
  
  
  METHODS
  We measured levels of MR-proANP, B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) in 999 community-dwelling subjects aged 70years who were participating in the PIVUS study.
  
  
  RESULTS
  The MR-proANP and the B-type natriuretic peptides exhibited similar associations to previous or prevalent cardiovascular disease, and echocardiographic data. In subgroups with confounding conditions (female sex, obesity, renal dysfunction), MR-proANP did not exhibit stronger associations to echocardiographic data than the B-type natriuretic peptides. MR-proANP predicted cardiovascular mortality during 8years of follow-up (adjusted hazard ratio 2.8 [95% confidence interval 1.3-6.1]) but not all-cause mortality (adjusted hazard ratio 1.6 [95% confidence interval 1.0-2.5]). Overall, NT-proBNP provided the strongest predictive value regarding both outcomes.
  
  
  CONCLUSIONS
  MR-proANP levels in an elderly community population are to a similar extent as the B-type natriuretic peptides related to manifestations of cardiovascular disease and echocardiographic data. MR-proANP also predicts long-term cardiovascular mortality but without being prognostically superior compared to the B-type natriuretic peptides.
authors: Department of Medical Sciences, Cardiology, Uppsala University, Uppsala, Sweden. kai.eggers@ucr.uu.se
authors: Kai M
authors: KM
authors: Eggers
authors: Per
authors: P
authors: Venge
authors: Lars
authors: L
authors: Lind
mesh_terms: D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D002318:Cardiovascular Diseases / Q000097:blood / Q000175:diagnosis*; D004452:Echocardiography; D005260:Female; D006801:Humans; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011379:Prognosis
chemical_list: D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor