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C-Type Natriuretic Peptides in Coronary Disease
Timothy C R Prickett1, Robert N Doughty2,3, Richard W Troughton4
1Department of Medicine, University of Otago, Christchurch, New Zealand; tim.prickett@otago.ac.nz.
Clinical Chemistry
|January 8, 2017
Summary
Plasma amino-terminal proCNP (NT-proCNP) is linked to kidney function and predicts outcomes in unstable angina patients, unlike other natriuretic peptides. This finding highlights NT-proCNP
Area of Science:
- Cardiovascular Medicine
- Nephrology
- Biomarker Research
Background:
- C-type natriuretic peptide (CNP) is a paracrine growth factor in vascular endothelium.
- Upregulation of CNP in atheromatous arteries suggests a role in coronary disease.
- The prognostic value of plasma CNP products in coronary artery disease (CAD) was previously unknown.
Purpose of the Study:
- Compare the prognostic value of plasma CNP products with other natriuretic peptides in CAD patients.
- Investigate associations between plasma CNP products, cardiac function, and renal function.
Main Methods:
- Measured plasma concentrations of CNP and NT-proCNP in 2129 individuals post-acute coronary syndrome.
- Related NP levels to cardiac/renal function, other NPs (ANP, BNP), and prognosis (mortality, cardiac readmission).
- Followed patients for a median of 4 years, with resampling at 4 and 12 months.
Main Results:
- Plasma NT-proCNP, unlike CNP, ANP, and BNP, correlated strongly with plasma creatinine (renal function).
- NT-proCNP concentrations remained stable in survivors, while other peptides declined.
- NT-proCNP independently predicted mortality and cardiac readmission in unstable angina, whereas NT-proBNP predicted outcomes in myocardial infarction.
Conclusions:
- Plasma NT-proCNP is strongly correlated with renal function.
- NT-proCNP is an independent predictor of mortality and cardiac readmission in unstable angina.
- NT-proCNP offers distinct prognostic information compared to NT-proBNP in specific CAD subgroups.
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