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Clinical Chemistry and Laboratory Medicine (CCLM)

Published in Association with the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM)

Editor-in-Chief: Plebani, Mario

Ed. by Gillery, Philippe / Lackner, Karl J. / Lippi, Giuseppe / Melichar, Bohuslav / Payne, Deborah A. / Schlattmann, Peter / Tate, Jillian R.

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IMPACT FACTOR 2017: 3.556

CiteScore 2017: 2.34

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Source Normalized Impact per Paper (SNIP) 2017: 1.188

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1437-4331
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Volume 49, Issue 4

Issues

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

Carmel M. Conlon
  • Department of Cardiology, St. Vincent’s University Hospital, Dublin, Ireland
  • School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Ireland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Ian Dawkins / Christina O’Loughlin / Denise Gibson / Cecily C. Kelleher
  • School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Ireland
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Mark Ledwidge / Kenneth McDonald
Published Online: 2011-01-31 | DOI: https://doi.org/10.1515/CCLM.2011.098

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), β-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.

Keywords: β-blockers; biomarker; epidemiology; heart rate; reference-chart

About the article

Corresponding author: Professor Kenneth McDonald, Department of Cardiology, St. Vincent’s University Hospital, Dublin 4, Ireland Phone: +353-1-284-5735, Fax: +353-1-230-4639


Received: 2010-05-12

Accepted: 2010-11-03

Published Online: 2011-01-31

Published in Print: 2011-04-01


Citation Information: Clinical Chemistry and Laboratory Medicine, Volume 49, Issue 4, Pages 719–728, ISSN (Online) 1437-4331, ISSN (Print) 1434-6621, DOI: https://doi.org/10.1515/CCLM.2011.098.

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Citing Articles

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[1]
Estefania Oliveros, Karolina Marinescu, Tisha Suboc, and Kim A Williams
Current Cardiovascular Risk Reports, 2018, Volume 12, Number 4
[2]
Kenneth McDonald, Richard Troughton, Ulf Dahlström, Henry Dargie, Henry Krum, Peter van der Meer, Theresa McDonagh, John J. Atherton, Ken Kupfer, Richard C. San George, Mark Richards, and Robert Doughty
European Journal of Heart Failure, 2018
[3]
Tobias Täger, Ann-Kathrin Wiedergruen, Hanna Fröhlich, Rita Cebola, Anna Corletto, Andrea Horsch, Georg Hess, Karen Slottje, Dietmar Zdunek, Hugo A. Katus, Frank H. Wians, and Lutz Frankenstein
Journal of Cardiac Failure, 2017
[4]
Patrick Collier, Chris J. Watson, Deidre F. Waterhouse, Ian R. Dawkins, Anil K. Patle, Stephen Horgan, Carmel M. Conlon, Rory O'Hanlon, John A. Baugh, Mark T. Ledwidge, and Kenneth McDonald
European Journal of Heart Failure, 2012, Volume 14, Number 9, Page 957
[5]
Gillian Murtagh, Ian R. Dawkins, Ronan O'Connell, Mallikarjuna Badabhagni, Anil Patel, Elaine Tallon, Rory O'Hanlon, Mark T. Ledwidge, and Kenneth M. McDonald
European Journal of Heart Failure, 2012, Volume 14, Number 5, Page 480

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