title: NT-proANP and NT-proBNP as prognostic markers in patients with acute decompensated heart failure of different etiologies.
abstract: OBJECTIVE
  Peak NT-proANP and NT-proBNP plasma levels after hospital admission may be of additional prognostic value in patients with acute decompensation of heart failure. The time-course of natriuretic plasma levels after hospital admission, and a possible influence of the underlying etiology on the time-course have not been sufficiently investigated.
  
  
  RESULTS
  Natriuretic peptide plasma levels of 85 patients with decompensated heart failure from ischemic and non-ischemic origins were measured at baseline and at 12h after hospital admission. NT-proBNP plasma levels on admission were lower compared to 12-hour-plasma levels, whereas NT-proANP plasma levels on admission were higher compared to 12-hour-plasma levels. Twenty-six patients (31%) died within the first 30 days. In patients who died within the first 30 days after admission NT-proANP and NT-proBNP plasma levels on admission and 12h later were significantly higher compared to survivors. Irrespective of different etiologies NT-proANP on admission and NT-proBNP 12h after admission were highest and demonstrated superior impact with respect to the prediction of 30-day-mortality.
  
  
  CONCLUSIONS
  NT-proANP and NT-proBNP are powerful markers of 30-day-mortality in patients with acute heart failure of ischemic and non-ischemic origins. With respect to the prediction of 30-day-mortality, NT-proBNP plasma levels at 12h after admission are comparable with NT-proANP plasma levels on admission. These data underline the fact that with regard to etiology-dependent hemodynamic changes and plasma half-time, the determination of peak plasma levels is of highest importance for the estimation of the impact of natriuretic peptides on the prognosis of patients with decompensated heart failure.
authors.affiliation: Department of Cardiology, University of Oldenburg, European Medical School, Germany. Electronic address: lueers.claus@klinikum-oldenburg.de.
authors.forename: Claus
authors.initials: C
authors.lastname: Luers
authors.affiliation: Department of Cardiology and Pneumology, University of Goettingen, Germany.
authors.forename: Anke
authors.initials: A
authors.lastname: Sutcliffe
authors.affiliation: Department of Clinical Chemistry, University of Goettingen, Germany.
authors.forename: Lutz
authors.initials: L
authors.lastname: Binder
authors.affiliation: Institute of Medical Biometry and Epidemiology, University of Marburg, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Irle
authors.affiliation: Department of Cardiology, University of Graz, Austria.
authors.forename: Burkert
authors.initials: B
authors.lastname: Pieske
mesh_terms: D000208:Acute Disease; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D005260:Female; D006333:Heart Failure / Q000097:blood* / Q000209:etiology* / Q000401:mortality; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D012372:ROC Curve; D012044:Regression Analysis; D013318:Stroke Volume; D016019:Survival Analysis
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D009320:Atrial Natriuretic Factor
keywords: Decompensated heart failure; Heart failure; NT-proANP; NT-proBNP; Natriuretic peptides; Prognosis