N-terminal prohormone B-type natriuretic peptide and cardiovascular risk in stable coronary artery disease: a meta-analysis of nine prospective studies.
To evaluate the prognostic value of N-terminal prohormone B-type natriuretic peptide (NT-proBNP) for patients with stable coronary artery disease, we searched for all published English-language articles indexed in MEDLINE and PubMed through July 2011. Nine independent, prospective, cohort studies that assessed the association between NT-proBNP value and long-term prognosis were identified. The interested endpoints of this meta-analysis were all-cause mortality and cardiovascular mortality and cardiovascular events. A general variance-based method was used to pool the hazard ratio (HR). In a comparison of individuals in the top quartile with those in the bottom quartile of baseline values of NT-proBNP, the combined adjusted HR was 2.74 (95% confidence interval [CI], 1.85-3.62). The combined HRs for the second and third quartiles compared with the first quartile were 1.33 (95% CI, 0.83-1.82) and 1.85 (95% CI, 1.23-2.48), respectively. In a subanalysis grouped by the median value, per 1 standard deviation increase or per 1000 pg/mL increase of NT-proBNP, the overall effect also showed that poor prognosis was significantly increased with the elevation of NT-proBNP (HR, 1.58; 95% CI, 1.16-2.01). Available prospective studies indicated strong associations between the circulating concentration of NT-proBNP and long-term prognosis in patients with stable coronary artery disease.
Department of Cardiology, Hangzhou First Municipal Hospital and Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China.
Gao
G
Wei
Department of Cardiology, Hangzhou First Municipal Hospital and Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China.
Ren
R
Yaqi
Department of Cardiology, Hangzhou First Municipal Hospital and Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China.
Wang
W
Ningfu
Department of Cardiology, Hangzhou First Municipal Hospital and Affiliated Hangzhou Hospital of Nanjing Medical University, Hangzhou, China.
Hou
H
Xuwei
D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D016017:Odds Ratio; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain