http://orcid.org/0000-0001-8505-4216
![Sample our Bioscience journals, sign in here to start your access, Latest two full volumes FREE to you for 14 days]({"type":"image" , "src" : "/sda/5925/TOC-Subject-Sample-2021-Bioscience.jpg"})
Abstract
Background: Amino-terminal-pro-B-type-natriuretic-peptide (NT-proBNP) is a diagnostic biomarker for heart failure (HF), but plasma concentrations are influenced by numerous factors. Mid-regional-pro-atrial-natriuretic-peptide (MR-proANP) have comparable diagnostic value in acute HF. However, data are lacking in the non-acute setting. This study sought to assess the diagnostic utility of MR-proANP in outpatients with a high risk of HF.
Methods: This prospective study included 399 outpatients. Inclusion criteria were: age ≥ 60 years, ≥1 risk factor for HF (diabetes, chronic kidney disease, vascular disease, atrial fibrillation, hypertension), without known or suspected HF. Unrecognized HF was diagnosed based on clinical signs, patient-reported symptoms and echocardiography. Plasma concentrations of MR-proANP and NT-proBNP were analysed.
Results: In total, 65 patients were diagnosed with HF or asymptomatic left ventricular systolic dysfunction (N = 12 LVEF ≤ 40%, N = 7 LVEF > 40% to ≤50%, N = 46 LVEF > 50%). Both MR-proANP (odds-ratio: 1.77; 95% CI:1.16–2.72; p = 0.009) and NT-proBNP (odds-ratio: 1.49; 95% CI:1.22–1.82; p < 0.001) were associated with HF. Area under receiver-operator characteristics curve (AUC) for the diagnosis of HF or asymptomatic left ventricular systolic dysfunction was higher for MR-proANP (AUC = 0.886; p < 0.001) and NT-proBNP (AUC = 0.910; p < 0.001) compared to patient-reported symptoms of HF (AUC = 0.830), but NT-proBNP added more diagnostic information compared to MR-proANP (p = 0.022).
Conclusions: Both NT-proBNP and MR-proANP are useful biomarkers in the diagnosis of HF or asymptomatic left ventricular systolic dysfunction in a non-acute setting. However, NT-proBNP added more diagnostic information compared to MR-proANP.
Acknowledgements
The authors are thankful for technical assistance of the employees at the Endocrine Research Laboratory, Herlev and Gentofte University Hospital, Denmark.
Ethics approval and consent to participate
The study was approved by the Committee on Health Research Ethics for the Capital Region of Denmark (H-3-2014-016) and conducted according to the Declaration of Helsinki. All patients provided written informed consent prior to participation.
Authors’ contributions
FG design of the work, the acquisition of data and the statistical analysis, the interpretation of data, have drafted the work. CK design of the work, interpretation of data, have substantively revised the work. TK the analysis of echocardiographic examinations, have substantively revised the work. CH the conception, have substantively revised the work. NT the conception, the interpretation of the echocardiographic data. KI interpretation of data have substantively revised the work. PH the acquisition of patients from the Clinic of Nephrology, have substantively revised the work. PK the analysis of biochemical tests, have substantively revised the work. JF the acquisition of patients from the Clinic of Diabetes, have substantively revised the work. LK the conception, have substantively revised the work. MS the conception, design of the work, interpretation of data, have substantively revised the work. All authors have approved the submitted version and have agreed to be personally accountable for the author’s own contributions.
Disclosure statement
The authors declare that they have no competing interests.
Availability of data and material
The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.