title: C-Type Natriuretic Peptides in Coronary Disease.
abstract: OBJECTIVE
  C-type natriuretic peptide (CNP) is a paracrine growth factor expressed in the vascular endothelium. Although upregulated in atheromatous arteries, the predictive value of plasma CNP products for outcome in coronary disease is unknown. This study aimed to compare the prognostic value of plasma CNP products with those of other natriuretic peptides in individuals with coronary artery disease, and investigate their associations with cardiac and renal function.
  
  
  RESULTS
  Plasma concentrations of CNP and amino-terminal proCNP (NT-proCNP) were measured at baseline in 2129 individuals after an index acute coronary syndrome admission and related to cardiac and renal function, other natriuretic peptides [atrial NP (ANP) and B-type NP (BNP)] and prognosis (primary end point, mortality; secondary end point, cardiac readmission). Median follow-up was 4 years. At baseline, and in contrast to CNP, ANP, and BNP, plasma NT-proCNP was higher in males and weakly related to cardiac function but strongly correlated to plasma creatinine. All NPs were univariately associated with mortality. Resampling at 4 and 12 months in survivors showed stable concentrations of NT-proCNP whereas all other peptides declined. When studied by diagnosis (myocardial infarction, unstable angina) at index admission using a multivariate model, NT-proBNP predicted mortality and readmission in myocardial infarction. In unstable angina, only NT-proCNP predicted both mortality and cardiac readmission.
  
  
  CONCLUSIONS
  In contrast to the close association of NT-proBNP with cardiac function, and predictive value for outcome after myocardial infarction, plasma NT-proCNP is highly correlated with renal function and is an independent predictor of mortality and cardiac readmission in individuals with unstable angina.
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand; tim.prickett@otago.ac.nz.
authors.forename: Timothy C R
authors.initials: TC
authors.lastname: Prickett
authors.affiliation: Department of Medicine, University of Auckland, Auckland, New Zealand.|Greenlane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Robert N
authors.initials: RN
authors.lastname: Doughty
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Richard W
authors.initials: RW
authors.lastname: Troughton
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Chris M
authors.initials: CM
authors.lastname: Frampton
authors.affiliation: Unitec, Auckland, New Zealand.
authors.forename: Gillian A
authors.initials: GA
authors.lastname: Whalley
authors.affiliation: Greenlane Cardiovascular Service, Auckland City Hospital, Auckland, New Zealand.
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Ellis
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: Eric A
authors.initials: EA
authors.lastname: Espiner
authors.affiliation: Department of Medicine, University of Otago, Christchurch, New Zealand.
authors.forename: A Mark
authors.initials: AM
authors.lastname: Richards
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000097:blood* / Q000175:diagnosis / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020098:Natriuretic Peptide, C-Type / Q000097:blood*; D011379:Prognosis
chemical_list: D015415:Biomarkers; D020098:Natriuretic Peptide, C-Type