IngentaConnect Plasma N-terminal Pro-atrial Natriuretic Peptide Predicts Death a...

Authors: Retterstol L.¹; Djurovic S.²; Bohn M.³; Bakken A.³; Erikssen J.⁴; Berg K.¹

Source: Scandinavian Cardiovascular Journal, Volume 35, Number 6, 1 December 2001 , pp. 373-378(6)

Abstract:

Objective—To assess N-terminal pro-atrial peptide (N-ANP) as a predictor of total and cardiac death in patients with previous premature myocardial infarction (MI). Design—In this prospective cohort study, we measured plasma N-ANP by ELIZA assays and ejection fraction (EF) by radionuclide ventriculography in a cohort of 247 patients (193 men and 54 women) who had had MI at a relatively young age (males: first MI at age

55; females

60). Results—After 10 years 44 patients had died, 36 from cardiac causes. After using a stepwise procedure to adjust for other prognostic factors (i.e. plasma total homocysteine (tHcy), C-reactive protein and age), the relative risk (RR) was 2.00 (95% confidence interval (CI) 1.05-3.80) (p = 0.03) for death of all causes and 2.32 (95% CI 1.19-4.55) (p = 0.01) for cardiac death when the top quartile was compared to the three lower quartiles of N-ANP. When radionuclide EF entered the Cox model, N-ANP became insignificant as a predictor of mortality. Conclusion—N-ANP was a significant predictor of total death and cardiac death in young survivors of MI, but radionuclide EF was a more independent prognostic variable.

Keywords: FOLLOW-UP STUDY; MYOCARDIAL INFARCTION; PRO-ATRIAL NATRIURETIC PEPTIDE; PROGNOSIS

Language: English

Document Type: Research article

Affiliations: 1: Department of Medical Genetics, Ullevål University Hospital, Oslo, & Institute of Medical Genetics, University of Oslo. 2: Department of Medical Genetics, Ullevål University Hospital, Oslo. 3: Department of Medical Genetics, Ulleva ring l University Hospital, Oslo. l University Hospital, Oslo. "> 4: Central Hospital of Akershus, Department of Medicine, Norway.

Plasma N-terminal Pro-atrial Natriuretic Peptide Predicts Death after Premature Myocardial Infarction, but not as well as Radionuclide Ejection Fraction. A Ten-year Follow-up Study