title: N-terminal pro B-type natriuretic peptide and angiogenic biomarkers in the prognosis of adverse outcomes in women with suspected preeclampsia.
abstract: BACKGROUND
  This study compares the performance of the soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF) ratio and the cardiac biomarker N-terminal pro-B type natriuretic peptide (NT-proBNP) in the prediction of adverse outcomes in women with suspicion of PE.
  
  
  METHODS
  A retrospective cohort study was conducted on women admitted at triage with signs and/or symptoms of PE (n=340). Serum levels of sFlt-1, PlGF and NT-proBNP were determined by an electrochemiluminescence immunoassay (Roche Diagnostics). The main outcomes were early- or late-onset PE and development of adverse outcome, defined as delivery within the first week since clinical presentation or fetal/early neonatal death.
  
  
  RESULTS
  NT-proBNP concentrations (ng/L) were significantly increased in PE versus non-PE women, both at <34 (169 versus 34) and ≥34weeks of gestation (101 versus 49) (p<0.001). A cut-point of 70 showed sensitivities/specificities of 78/74% for early-, and 70/62% for late-onset PE; slightly lower than those offered by the sFlt-1/PlGF ratio or uric acid. The respective cut-points of 178 and 219 for sFlt-1/PlGF ratio and NT-proBNP, demonstrated similar performance in the prediction of adverse outcome, with sensitivity/specificity of 95/84% and 94/76%, respectively.
  
  
  CONCLUSIONS
  NT-proBNP and sFlt-1/PlGF ratio can be used to predict the development of an adverse outcome.
authors.affiliation: Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Indira
authors.initials: I
authors.lastname: Álvarez-Fernández
authors.affiliation: Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain; Biochemistry and Molecular Biology Department, University of Oviedo, Spain.
authors.forename: Belén
authors.initials: B
authors.lastname: Prieto
authors.affiliation: Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Verónica
authors.initials: V
authors.lastname: Rodríguez
authors.affiliation: Obstetric and Gynecology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Ruano
authors.affiliation: Obstetric and Gynecology Service, Hospital Universitario Central de Asturias, Oviedo, Spain.
authors.forename: Ana I
authors.initials: AI
authors.lastname: Escudero
authors.affiliation: Clinical Biochemistry, Laboratory of Medicine, Hospital Universitario Central de Asturias, Oviedo, Spain; Biochemistry and Molecular Biology Department, University of Oviedo, Spain. Electronic address: falvarezmen@gmail.com.
authors.forename: Francisco V
authors.initials: FV
authors.lastname: Álvarez
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000097:blood*; D005260:Female; D005865:Gestational Age; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D018919:Neovascularization, Physiologic; D010446:Peptide Fragments / Q000097:blood*; D000072483:Placenta Growth Factor / Q000097:blood*; D011225:Pre-Eclampsia / Q000097:blood* / Q000175:diagnosis; D011247:Pregnancy; D011256:Pregnancy Outcome; D011379:Prognosis; D012189:Retrospective Studies; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000097:blood*
chemical_list: D015415:Biomarkers; C000608036:PGF protein, human; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D000072483:Placenta Growth Factor; C501162:FLT1 protein, human; D040281:Vascular Endothelial Growth Factor Receptor-1
keywords: N-terminal pro b-type natriuretic peptide; Placental growth factor; Preeclampsia; Pregnancy; Soluble vascular endothelial growth factor receptor-1