title: B-type natriuretic peptides for the prediction of cardiovascular events in patients with stable coronary heart disease: the Heart and Soul Study.
abstract: BACKGROUND
  Brain-type natriuretic peptide (BNP) and the amino-terminal fragment of its prohormone (NT-proBNP) are known predictors of cardiovascular outcomes in patients with coronary heart disease; however, the relative prognostic value of these 2 biomarkers for secondary events remains unclear.
  
  
  RESULTS
  In 983 participants with stable coronary heart disease, we evaluated the association of BNP and NT-proBNP with time to hospitalization for heart failure, nonfatal myocardial infarction, stroke or transient ischemic attack, cardiovascular death, and combined major adverse cardiovascular events (MACE). During an average follow-up of 6.5±3.3 years, both BNP and NT-proBNP were associated with increased risk of MACE in a multivariable-adjusted model (hazard ratio per standard deviation of log BNP: 1.58; 95% CI: 1.32 to 1.89; hazard ratio per standard deviation of log NT-proBNP: 1.84; 95% CI: 1.52 to 2.24). When added to traditional risk factors, NT-proBNP predicted MACE better than BNP (C statistic: 0.76 versus 0.72, P<0.001). Similarly, the addition of NT-proBNP resulted in a greater net reclassification improvement for predicting MACE than the addition of BNP (65% for NT-proBNP, 56% for BNP).
  
  
  CONCLUSIONS
  Both BNP and NT-proBNP were significant predictors of MACE in stable coronary heart disease; however, NT-proBNP was superior to BNP for net risk reclassification for MACE.
authors: Department of Medicine, University of California, San Francisco, California (R.K.M., A.L.B., R.J., M.A.W.) San Francisco Veterans Affairs Medical Center, San Francisco, California (R.K.M., M.R., M.A.W.).
authors: Rakesh K
authors: RK
authors: Mishra
authors: Department of Medicine, University of California, San Francisco, California (R.K.M., A.L.B., R.J., M.A.W.).
authors: Alexis L
authors: AL
authors: Beatty
authors: Department of Medicine, University of California, San Francisco, California (R.K.M., A.L.B., R.J., M.A.W.).
authors: Rajesh
authors: R
authors: Jaganath
authors: San Francisco Veterans Affairs Medical Center, San Francisco, California (R.K.M., M.R., M.A.W.).
authors: Mathilda
authors: M
authors: Regan
authors: Departments of Pathology & Laboratory Medicine, University of California, San Francisco, California (A.H.W.).
authors: Alan H B
authors: AH
authors: Wu
authors: Department of Medicine, University of California, San Francisco, California (R.K.M., A.L.B., R.J., M.A.W.) San Francisco Veterans Affairs Medical Center, San Francisco, California (R.K.M., M.R., M.A.W.).
authors: Mary A
authors: MA
authors: Whooley
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003327:Coronary Disease / Q000097:blood* / Q000000981:diagnostic imaging / Q000401:mortality; D004452:Echocardiography; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000000981:diagnostic imaging / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000453:epidemiology; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D011446:Prospective Studies; D065840:Protective Factors; D018570:Risk Assessment; D020521:Stroke / Q000097:blood / Q000453:epidemiology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: BNP; NT‐proBNP; adverse cardiovascular outcomes; risk assessment; stable coronary heart disease