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(Circulation. 2005;112:9-11.)
© 2005 American Heart Association, Inc.

Editorial

N-Terminal-Pro-B–Type Natriuretic Peptide

Universal Marker of Cardiovascular Risk?

A. Mark Richards, MD, PhD, DSc, FRACP; Christopher M. Frampton, BSc, PhD

From the Department of Medicine, Christchurch School of Medicine and Health Sciences, Christchurch, New Zealand.

Correspondence to Prof A. Mark Richards, Dept of Medicine, Christchurch School of Medicine and Health Sciences, PO Box 4345, Riccarton Ave, Christchurch, New Zealand. E-mail mark.richards@cdhb.govt.nz

Key Words: Editorials • cardiovascular diseases • coronary disease • natriuretic peptides • renin

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Plasma brain-type natriuretic peptide (BNP) and amino-terminal proBNP (NTproBNP) provide prognostic information on cardiovascular morbidity and mortality beyond that provided by standard risk factors. Clinical applications of B-type peptides under ongoing research include their use in diagnosing acute heart failure (HF), in risk stratification in both acute and established HF, in acute coronary syndromes (ACS), in asymptomatic populations at cardiovascular risk (older adults and people with hypertension), and as part of a screening strategy for detection of left ventricular impairment and prediction of cardiovascular risk in the general population.^1,2 In this issue of Circulation, Campbell and colleagues³ assess the ability of NTproBNP to predict myocardial infarction (MI) in subjects who have experienced a cerebrovascular event. NTproBNP (reflecting cardiac distension) is compared with C-reactive protein (a systemic marker of inflammation) and renin (a marker of sodium status regulated by renal perfusion and delivery of sodium to the renal glomerulus).

See p 110

The nested case-control study is from the 6105 participants in the Perindopril Protection Against Recurrent Stroke Study (PROGRESS), a placebo-controlled study of converting enzyme inhibitor–based therapy in patients with previous cerebrovascular events.⁴ Within PROGRESS, 206 subjects incurred an MI during 3.9 years of follow-up. The investigators matched those incurring an MI with control PROGRESS patients avoiding MI from time of randomization to time of case ascertainment. Cases and controls were matched for age, gender, treatment allocation, region, and cerebrovascular qualifying event. The form of matching meant that individual patients may have been controls initially and subsequently became cases . . . [Full Text of this Article]

Related Article:

Prediction of Myocardial Infarction by N-Terminal-Pro-B-Type Natriuretic Peptide, C-Reactive Protein, and Renin in Subjects With Cerebrovascular Disease

Duncan J. Campbell, Mark Woodward, John P. Chalmers, Samuel A. Colman, Alicia J. Jenkins, Bruce E. Kemp, Bruce C. Neal, Anushka Patel, and Stephen W. MacMahon
Circulation 2005 112: 110-116. [Abstract] [Full Text]