Prediction of Mortality by High-Sensitivity C-Reactive Protein and Brain Natriuretic Peptide in Patients With Dilated Cardiomyopathy

Background Two preconditioning stimuli should induce a more consistent overall cell protection. We hypothesized that remote ischemic preconditioning (RIPC, second preconditioning stimulus) applied during isoflurane inhalation (first preconditioning stimulus) would provide more protection to the myocardium of patients undergoing on-pump coronary artery bypass grafting. Methods In this placebo-controlled randomized controlled study, patients in the RIPC group received four 5-min cycles of 300 mmHg cuff inflation/deflation of the leg before aortic cross-clamping. Anesthesia consisted of opioids and propofol for induction and isoflurane for maintenance. The primary outcome was high-sensitivity cardiac troponin T release. Secondary endpoints were plasma levels of N-terminal pro-brain natriuretic peptide, high-sensitivity C-reactive protein, S100 protein, and short- and long-term clinical outcomes. Gene expression profiles were obtained from atrial tissue using microarrays. Results RIPC (n = 27) did not reduce high-sensitivity cardiac troponin T release when compared with placebo (n = 28). Likewise, N-terminal pro-brain natriuretic peptide, a marker of myocardial dysfunction; high-sensitivity C-reactive protein, a marker of perioperative inflammatory response; and S100, a marker of cerebral injury, were not different between the groups. The incidence for the perioperative composite endpoint combining new arrhythmias and myocardial infarctions was higher in the RIPC group than the placebo group (14/27 vs. 6/28, P = 0.036). However, there was no difference in the 6-month cardiovascular outcome. N-terminal pro-brain natriuretic peptide release correlated with isoflurane-induced transcriptional changes in fatty-acid metabolism (P = 0.001) and DNA-damage signaling (P < 0.001), but not with RIPC-induced changes in gene expression. Conclusions RIPC applied during isoflurane inhalation provides no benefit to the myocardium of patients undergoing on-pump coronary artery bypass grafting.

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Correlation of Urine Albumin/Creatinine Ratio (UACR), High Sensitivity C-Reactive Protein (hsCRP) and N-Terminal Pro Brain Natriuretic Peptide (NT-proBNP) with Atherosclerosis (OxLDL) in Centrally Obese Men

The Indonesian Biomedical Journal ◽

10.18585/inabj.v3i1.132 ◽

2011 ◽

Vol 3 (1) ◽

pp. 37

Author(s):

Nancy Pakpahan ◽

Mansyur Arif ◽

Ilhamjaya Patellongi

Keyword(s):

Cardiovascular Disease ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

High Sensitivity ◽

Creatinine Ratio ◽

C Reactive Protein ◽

Albumin Creatinine Ratio ◽

Reactive Protein ◽

Urine Albumin ◽

Urine Albumin Creatinine Ratio

BACKGROUND: Obesity is closely associated with atherosclerosis risk and cardiovascular disease. Novel cardiovascular risk biomarkers such as Urine Albumin/Creatinine Ratio (UACR), High Sensitivity C-Reactive Protein (hsCRP) and N-Terminal pro Brain Natriuretic Peptide (NT-proBNP) have been observed to predict cardiovascular disease in the general population. The aim of this study was to observe the correlation of UACR, hsCRP and NT-proBNP with atherosclerosis (OxLDL) in centrally obese men.METHODS: The study was observational with a cross sectional design done on 76 male subjects aged 30–50 years with central obesity and mean of age of 37 years. Urine albumin was determined by PEG enhanced immunoturbidimetric assay, urine creatinine by Jaffe without deproteinase, hsCRP by chemiluminescent immunometric assay, NT-proBNP by electrochemiluminescence (ECLIA) and OxLDL by ELISA.RESULTS: There was significant correlation between hsCRP and OxLDL (r=0.230, p=0.046). There was no significant correlation between UACR and OxLDL (r=-0.138, p=0.236), neither between Log NT-proBNP and OxLDL (r=-0.173, p=0.136).CONCLUSIONS: Atherosclerosis was significantly correlated with hsCRP (low grade inflammation).KEYWORDS: NT-proBNP, UACR, hsCRP, OxLDL, atherosclerosis

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Pentraxin-3 vs C-reactive protein and other prognostic biomarkers in acute coronary syndrome: A substudy of the Platelet Inhibition and Patients Outcomes (PLATO) trial

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872619846334 ◽

2019 ◽

Vol 9 (4) ◽

pp. 313-322 ◽

Cited By ~ 3

Author(s):

Frederic Kontny ◽

Thomas Andersen ◽

Thor Ueland ◽

Axel Åkerblom ◽

Tatevik G Lakic ◽

...

Keyword(s):

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Troponin T ◽

High Sensitivity ◽

Pentraxin 3 ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome ◽

High Sensitivity Troponin ◽

High Sensitivity Troponin T

Aims: We investigated the dynamics, associations with patient characteristics, other biomarkers, and clinical outcomes of pentraxin 3 in acute coronary syndrome. Methods and results: In multivariate analyses, pentraxin 3 measured in 5154 patients randomised in the Platelet Inhibition and Patients Outcomes (PLATO) trial (NCT00391872) was compared with leukocytes, high-sensitivity C-reactive protein, interleukin-6, cystatin C, N-terminal prohormone brain natriuretic peptide, high-sensitivity troponin T and growth differentiation factor 15 concerning prediction of clinical outcome. Pentraxin 3 peaked earlier than high-sensitivity C-reactive protein and was more strongly correlated with N-terminal prohormone brain natriuretic peptide and high-sensitivity troponin T than with high-sensitivity C-reactive protein. The frequency of cardiovascular death, spontaneous myocardial infarction or stroke by quartiles of pentraxin 3 at admission was 6.1%, 7.3%, 9.7% and 10.7%, respectively ( p<0.0001). The hazard ratio per 50% increase of pentraxin 3 was 1.13 (95% confidence interval: 1.07–1.19), p<0.0001. This association remained significant after stepwise adjustments for leukocytes/high-sensitivity C-reactive protein (1.09 (1.02–1.15)), p=0.009, interleukin-6 (1.07 (1.01–1.14)), p=0.026, and cystatin C (1.07 (1.00–1.13)), p=0.044, but not after adjustment for N-terminal prohormone brain natriuretic peptide, high-sensitivity troponin T and growth differentiation factor 15. Admission pentraxin 3 was also associated with several of the individual endpoint components (cardiovascular death/spontaneous myocardial infarction; p=0.008, cardiovascular death; p=0.026, and spontaneous myocardial infarction; p=0.017), but not with stroke. Pentraxin 3 measured in the chronic phase (i.e. at one month) was still predictive of the composite endpoint in univariate analysis (1.12 (1.04–1.20) per 50% increase) p=0.0024, but not after adjustment for the other biomarkers. Conclusion: Admission level of pentraxin 3 is a modestly stronger predictor than high-sensitivity C-reactive protein and interleukin-6, but not than N-terminal prohormone brain natriuretic peptide or high-sensitivity troponin T, concerning cardiovascular outcome in acute coronary syndrome. Pentraxin 3 is more strongly correlated with N-terminal prohormone brain natriuretic peptide and high-sensitivity troponin T than with high-sensitivity C-reactive protein.

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Cardiovascular risk prediction by N-terminal pro brain natriuretic peptide and high sensitivity C-reactive protein is affected by age and sex

Journal of Hypertension ◽

10.1097/hjh.0b013e3282f18301 ◽

2008 ◽

Vol 26 (1) ◽

pp. 26-34 ◽

Cited By ~ 32

Author(s):

Michael H Olsen ◽

Tine W Hansen ◽

Marina K Christensen ◽

Finn Gustafsson ◽

Susanne Rasmussen ◽

...

Keyword(s):

Cardiovascular Risk ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Risk Prediction ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Cardiovascular Risk Prediction ◽

Age And Sex

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Vitamin D Predicts All-Cause and Cardiac Mortality in Females with Suspected Acute Coronary Syndrome: A Comparison with Brain Natriuretic Peptide and High-Sensitivity C-Reactive Protein

Cardiology Research and Practice ◽

10.1155/2013/398034 ◽

2013 ◽

Vol 2013 ◽

pp. 1-8 ◽

Cited By ~ 7

Author(s):

Patrycja A. Naesgaard ◽

Ricardo A. León de la Fuente ◽

Stein Tore Nilsen ◽

Leik Woie ◽

Torbjoern Aarsland ◽

...

Keyword(s):

Vitamin D ◽

Acute Coronary Syndrome ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Cardiac Death ◽

High Sensitivity ◽

C Reactive Protein ◽

Reactive Protein ◽

Coronary Syndrome ◽

Gender Specific

Vitamin D may not only reflect disease but may also serve as a prognostic indicator. Our aim was to assess the gender-specific utility of vitamin D measured as 25-hydroxy-vitamin D [25(OH)D] to predict all-cause and cardiac death in patients with suspected acute coronary syndrome (ACS) and to compare its prognostic utility to brain natriuretic peptide (BNP) and high-sensitivity C-reactive protein (hsCRP). Blood samples were harvested on admission in 982 patients. Forty percent were women (65.9 ± 12.6 years). Mortality was evaluated in quartiles of 25(OH)D, BNP, and hsCRP, respectively, during a 5-year follow-up, applying univariate and multivariate analyses. One hundred and seventy-three patients died; 78 were women. In 92 patients (37 women), death was defined as cardiac. In women, the univariate hazard ratio (HR) for total death of 25(OH)D in Quartile (Q) 2 versus Q1, Q3 versus Q1, and Q4 versus Q1 was 0.55 (95% CI 0.33–0.93), 0.29 (95% CI 0.15–0.55), and 0.13 (95% CI 0.06–0.32), respectively. In females, it was an independent predictor of total and cardiac death, whereas BNP and hsCRP were less gender-specific. No gender differences in 25(OH)D were noted in a reference material. Accordingly, vitamin D independently predicts mortality in females with suspected ACS.

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