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Increased circulating levels of natriuretic peptides predict future cardiac event in patients with chronic
Takatoshi Goto1, Hiroyuki Takase, Takayuki Toriyama
1Department of Internal Medicine, Enshu General Hospital, Hamamatsu, Japan.
Insights
Elevated levels of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) predict future cardiac events in patients undergoing chronic hemodialysis, aiding in risk assessment.
Area of Science:
- Nephrology
- Cardiology
- Biomarkers
Background:
- Cardiovascular events significantly impact prognosis in chronic hemodialysis patients.
- Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are cardiac hormones.
- Predictive value of ANP and BNP for cardiac events in hemodialysis patients is under investigation.
Purpose of the Study:
- To investigate whether elevated plasma levels of ANP and BNP predict future cardiac events in chronic hemodialysis patients.
- To assess the clinical utility of ANP and BNP as predictive biomarkers for cardiac events in this population.
Main Methods:
- Fifty-three asymptomatic chronic hemodialysis patients were enrolled.
- Plasma levels of ANP and BNP were measured.
- Patients were followed for a median of 11.3 months for cardiac events.
Main Results:
- Cardiac events occurred in 13 patients.
- Patients with cardiac events had significantly higher ANP and BNP levels compared to those without.
- Cut-off levels for ANP and BNP were determined as 58 and 390 pg/ml, respectively.
- Higher ANP or BNP levels were associated with a significantly greater incidence of cardiac events.
Conclusions:
- Elevated plasma ANP and BNP levels are indicative of an increased risk of cardiac events in hemodialysis patients.
- ANP and BNP are clinically useful biomarkers for predicting cardiac events in this patient group.
Background/Aims:
Cardiovascular events are the major determinant of the prognosis in patients with chronic hemodialysis. The present study was designed to investigate whether increased plasma levels of atrial or brain natriuretic peptides (ANP or BNP) predict future cardiac events in such patients.
Methods:
Fifty-three patients undergoing chronic hemodialysis without clinical symptoms suggestive of cardiac disorders were enrolled and their blood was sampled for ANP and BNP measurements. Electrocardiograms demonstrated left ventricular hypertrophy in 28 patients but no other abnormal findings. We followed them up for 11.3 +/- 0.2 months. The endpoint was cardiac events.
Results:
Cardiac events occurred in 13 patients (CE group). Both ANP and BNP levels were higher in CE group than in patients without cardiac events (ANP: 118 +/- 21 vs. 56 +/- 5 pg/ml, BNP: 769 +/- 204 vs. 193 +/- 25 pg/ml, respectively). Receiver operating characteristics curve revealed that the cut-off levels of ANP and BNP were 58 and 390 pg/ml, respectively. Using the Kaplan-Meier method, the incidence of cardiac events was significantly greater in patients with higher levels of ANP (50.0 vs. 0.0%) or BNP (72.7 vs. 11.9%) than in those with lower levels of the peptides.
Conclusions:
Elevated levels of ANP or BNP indicate an increased risk of cardiac events and these peptides are clinically useful to predict cardiac events in patients with hemodialysis.
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