TY - JOUR
T1 - N-terminal proatrial natriuretic factor
T2 - An independent predictor of long- term prognosis after myocardial infarction
AU - Hall, Christian
AU - Rouleau, Jean L.
AU - Moyè, Lemuel
AU - De Champlain, Jacques
AU - Bichet, Daniel
AU - Klein, Marc
AU - Sussex, Bruce
AU - Packer, Milton
AU - Rouleau, Jacques
AU - Arnold, Malcolm O.
AU - Lamas, Gervasio A.
AU - Sestier, Francois
AU - Gottlieb, Stephen S.
AU - Wun, Chuan Chuan C
AU - Pfeffer, Marc A.
PY - 1994
Y1 - 1994
N2 - 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.
AB - 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.
KW - atrial natriuretic factor
KW - congestive heart failure
KW - myocardial infarction
KW - prognosis
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U2 - 10.1161/01.CIR.89.5.1934
DO - 10.1161/01.CIR.89.5.1934
M3 - Article
C2 - 8181115
AN - SCOPUS:0028214843
SN - 0009-7322
VL - 89
SP - 1934
EP - 1942
JO - Circulation
JF - Circulation
IS - 5
ER -