B-type natriuretic peptide measurement in primary care; magnitude of associations with cardiovascular risk factors and their therapies. Observations from the STOP-HF (St. Vincent's Screening TO Prevent Heart Failure) study.

Hdl Handle:
http://hdl.handle.net/10147/207554
Title:
B-type natriuretic peptide measurement in primary care; magnitude of associations with cardiovascular risk factors and their therapies. Observations from the STOP-HF (St. Vincent's Screening TO Prevent Heart Failure) study.
Authors:
Conlon, Carmel M; Dawkins, Ian; O'Loughlin, Christina; Gibson, Denise; Kelleher, Cecily C; Ledwidge, Mark; McDonald, Kenneth
Affiliation:
Department of Cardiology, St. Vincent's University Hospital, Dublin, Ireland.
Citation:
Clin Chem Lab Med. 2011 Apr;49(4):719-28. Epub 2011 Jan 31.
Journal:
Clinical chemistry and laboratory medicine : CCLM / FESCC
Issue Date:
1-Feb-2012
URI:
http://hdl.handle.net/10147/207554
DOI:
10.1515/CCLM.2011.098
PubMed ID:
21275814
Abstract:
BACKGROUND: An effective prevention strategy for heart failure in primary care requires a reliable screening tool for asymptomatic ventricular dysfunction. Preliminary data indicate that B-type natriuretic peptide (BNP) may be suitable for this task. However, for the most effective use of this peptide, the interrelationships between associated risk factors and their therapies on BNP, and in particular their magnitude of effect, needs to be established in a large primary care population. Therefore, the objective of the study was to establish the extent of the association between BNP, cardiovascular risk factors and their therapies. METHODS: BNP measurement and clinical review was preformed on 1122 primary care patients with cardiovascular risk factors. Multivariate analyses identified significant associates of BNP concentrations which were further explored to establish the magnitude of their association. RESULTS: Associates of BNP were age (1.36-fold increase in BNP/decade), female (1.28), beta-blockers (1.90), myocardial infarction (1.36), arrhythmia (1.98), diastolic blood pressure; all p<0.01. A novel method was devised that plotted median BNP per sliding decade of age for the various combinations of these principal associates. CONCLUSIONS: The data presented underline the importance of considering several clinical and therapeutic factors when interpreting BNP concentrations. Most of these variables were associated with increased concentrations, which may in part explain the observed false-positive rates for detecting ventricular dysfunction using this peptide. Furthermore, the design of studies or protocols using BNP as an endpoint or a clinical tool should take particular account of these associations. This analysis provides the foundation for age, risk factor and therapy adjusted reference ranges for BNP in this setting.
Language:
eng
MeSH:
Adult; Aged; Blood Chemical Analysis/*methods/standards; Female; Heart Failure/*blood/diagnosis/prevention & control/therapy; Humans; Male; Middle Aged; Multivariate Analysis; Natriuretic Peptide, Brain/*blood; *Primary Health Care; Reference Values; Risk Factors
ISSN:
1434-6621 (Print); 1434-6621 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorConlon, Carmel Men_GB
dc.contributor.authorDawkins, Ianen_GB
dc.contributor.authorO'Loughlin, Christinaen_GB
dc.contributor.authorGibson, Deniseen_GB
dc.contributor.authorKelleher, Cecily Cen_GB
dc.contributor.authorLedwidge, Marken_GB
dc.contributor.authorMcDonald, Kennethen_GB
dc.date.accessioned2012-02-01T10:31:10Z-
dc.date.available2012-02-01T10:31:10Z-
dc.date.issued2012-02-01T10:31:10Z-
dc.identifier.citationClin Chem Lab Med. 2011 Apr;49(4):719-28. Epub 2011 Jan 31.en_GB
dc.identifier.issn1434-6621 (Print)en_GB
dc.identifier.issn1434-6621 (Linking)en_GB
dc.identifier.pmid21275814en_GB
dc.identifier.doi10.1515/CCLM.2011.098en_GB
dc.identifier.urihttp://hdl.handle.net/10147/207554-
dc.description.abstractBACKGROUND: An effective prevention strategy for heart failure in primary care requires a reliable screening tool for asymptomatic ventricular dysfunction. Preliminary data indicate that B-type natriuretic peptide (BNP) may be suitable for this task. However, for the most effective use of this peptide, the interrelationships between associated risk factors and their therapies on BNP, and in particular their magnitude of effect, needs to be established in a large primary care population. Therefore, the objective of the study was to establish the extent of the association between BNP, cardiovascular risk factors and their therapies. METHODS: BNP measurement and clinical review was preformed on 1122 primary care patients with cardiovascular risk factors. Multivariate analyses identified significant associates of BNP concentrations which were further explored to establish the magnitude of their association. RESULTS: Associates of BNP were age (1.36-fold increase in BNP/decade), female (1.28), beta-blockers (1.90), myocardial infarction (1.36), arrhythmia (1.98), diastolic blood pressure; all p<0.01. A novel method was devised that plotted median BNP per sliding decade of age for the various combinations of these principal associates. CONCLUSIONS: The data presented underline the importance of considering several clinical and therapeutic factors when interpreting BNP concentrations. Most of these variables were associated with increased concentrations, which may in part explain the observed false-positive rates for detecting ventricular dysfunction using this peptide. Furthermore, the design of studies or protocols using BNP as an endpoint or a clinical tool should take particular account of these associations. This analysis provides the foundation for age, risk factor and therapy adjusted reference ranges for BNP in this setting.en_GB
dc.language.isoengen_GB
dc.subject.meshAdulten_GB
dc.subject.meshAgeden_GB
dc.subject.meshBlood Chemical Analysis/*methods/standardsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHeart Failure/*blood/diagnosis/prevention & control/therapyen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMultivariate Analysisen_GB
dc.subject.meshNatriuretic Peptide, Brain/*blooden_GB
dc.subject.mesh*Primary Health Careen_GB
dc.subject.meshReference Valuesen_GB
dc.subject.meshRisk Factorsen_GB
dc.titleB-type natriuretic peptide measurement in primary care; magnitude of associations with cardiovascular risk factors and their therapies. Observations from the STOP-HF (St. Vincent's Screening TO Prevent Heart Failure) study.en_GB
dc.contributor.departmentDepartment of Cardiology, St. Vincent's University Hospital, Dublin, Ireland.en_GB
dc.identifier.journalClinical chemistry and laboratory medicine : CCLM / FESCCen_GB
dc.description.provinceLeinster-

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