N-terminal proatrial natriuretic factor. An independent predictor of long-term prognosis after myocardial infarction
| Autor: | Christian Hall, B Sussex, D Bichet, Lemuel A. Moyé, M Packer, M Klein, J Rouleau, M O Arnold, J L Rouleau, J. De Champlain |
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| Rok vydání: | 1994 |
| Předmět: |
Male
medicine.medical_specialty Captopril Time Factors Heart disease Prohormone Myocardial Infarction Infarction Atrial natriuretic peptide Predictive Value of Tests Risk Factors Physiology (medical) Internal medicine medicine Humans Prospective Studies cardiovascular diseases Myocardial infarction Protein Precursors Heart Failure Ejection fraction business.industry Peptide secretion Middle Aged Prognosis medicine.disease Peptide Fragments Endocrinology Heart failure Multivariate Analysis cardiovascular system Cardiology Female Cardiology and Cardiovascular Medicine business Atrial Natriuretic Factor Follow-Up Studies medicine.drug |
| Zdroj: | Circulation. 89:1934-1942 |
| ISSN: | 1524-4539 0009-7322 |
| DOI: | 10.1161/01.cir.89.5.1934 |
| Popis: | BACKGROUND Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly. METHODS AND RESULTS To test the prognostic value of N-terminal proANF after myocardial infarction, its plasma concentration was measured a mean of 12 days after infarction in 246 patients in the Survival and Ventricular Enlargement (SAVE) Study. N-terminal proANF was a much stronger predictor of survival than ANF itself. Furthermore, in multivariate analysis of cardiovascular mortality and development of heart failure, N-terminal proANF in contrast to ANF and other neurohormones was still a powerful and independent predictor when the model included age, gender, prior myocardial infarction, hypertension, diabetes, use of thrombolysis, Killip class, infarct location, and LVEF. CONCLUSIONS The measurement of N-terminal proANF supplements presently used clinical and objective assessments and provides an important independent predictor of prognosis with respect to cardiovascular mortality and development of heart failure. |
| Databáze: | OpenAIRE |
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