Prediction of heart failure by amino terminal-pro-B-type natriuretic peptide and C-reactive protein in subjects with cerebrovascular disease.

Campbell, D; Woodward, M; Chalmers, J; Colman, SA; Jenkins, A; Kemp, B; Neal, B; Patel, A; MacMahon, S

Journal article

Prediction of heart failure by amino terminal-pro-B-type natriuretic peptide and C-reactive protein in subjects with cerebrovascular disease.

Abstract:: B-type natriuretic peptide (BNP) and C-reactive protein (CRP) are elevated in persons at risk for congestive heart failure (CHF). However, limited data are available directly comparing BNP-related peptides and CRP in persons at risk of CHF. To evaluate amino terminal-pro-BNP (NT-proBNP) and CRP, separately and together, for assessment of risk of CHF, we performed a nested case-control study of the 6105 participants of the Perindopril pROtection aGainst REcurrent Stroke Study (PROGRESS), a placebo-controlled study of a perindopril-based blood pressure-lowering regimen among individuals with previous stroke or transient ischemic attack (TIA). Each of 258 subjects who developed CHF resulting in death, hospitalization, or withdrawal of randomized therapy during a mean follow-up of 3.9 years was matched to 1 to 3 control subjects. NT-proBNP and CRP predicted CHF; the odds ratio for subjects in the highest compared with the lowest quarter was 4.5 (95% confidence interval, 2.7 to 7.5) for NT-proBNP and 2.9 (confidence interval, 1.9 to 4.7) for CRP, and each remained a predictor of CHF after adjustment for all other predictors. Screening for both markers provided better prognostic information than screening for either alone. Elevation of NT-proBNP above 50 pmol/L and CRP above 0.84 mg/L predicted CHF with sensitivity of 64% and specificity of 66%. NT-proBNP and CRP predicted CHF in subjects receiving perindopril-based therapy. We conclude that NT-proBNP and CRP are independent predictors of CHF risk after stroke or TIA. Moreover, NT-proBNP and CRP may be markers of mechanisms of CHF pathogenesis distinct from those responsive to angiotensin-converting enzyme inhibitor-based therapy.

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APA Style

Campbell, D., Woodward, M., Chalmers, J., Colman, S. A., Jenkins, A., Kemp, B., Neal, B., Patel, A., & MacMahon, S. (2005). Prediction of heart failure by amino terminal-pro-B-type natriuretic peptide and C-reactive protein in subjects with cerebrovascular disease. Hypertension, 45(1), 69–74.

MLA Style

Campbell, D., et al. “Prediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects with Cerebrovascular Disease.” Hypertension, vol. 45, no. 1, 2005, pp. 69–74.

Chicago Style

Campbell, D, M Woodward, J Chalmers, SA Colman, A Jenkins, B Kemp, B Neal, A Patel, and S MacMahon. 2005. “Prediction of Heart Failure by Amino Terminal-pro-B-Type Natriuretic Peptide and C-Reactive Protein in Subjects with Cerebrovascular Disease.” Hypertension 45 (1): 69–74.
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