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Inflammation increases NT-proBNP and the NT-proBNP/BNP ratio.

Artikel i vetenskaplig tidskrift
Författare Juliana Jensen
Li-Ping Ma
Michael Fu
David Svaninger
Per-Arne Lundberg
Ola Hammarsten
Publicerad i Clinical research in cardiology : official journal of the German Cardiac Society
Volym 99
Nummer/häfte 7
Sidor 445-452
ISSN 1861-0692
Publiceringsår 2010
Publicerad vid Institutionen för kemi
Institutionen för biomedicin, avdelningen för klinisk kemi och transfusionsmedicin
Institutionen för biomedicin
Institutionen för medicin
Sidor 445-452
Språk en
Länkar dx.doi.org/10.1007/s00392-010-0140-...
Ämnesord Aged, Aged, 80 and over, Biological Markers, blood, Female, Glomerular Filtration Rate, Heart Failure, blood, Humans, Inflammation, blood, Kidney Function Tests, Male, Mathematical Computing, Middle Aged, Natriuretic Peptide, Brain, blood, Odds Ratio, Peptide Fragments, blood, Prognosis, Retrospective Studies, Severity of Illness Index
Ämneskategorier Kemi

Sammanfattning

Plasma BNP and NT-proBNP are often regarded as interchangeable parameters in assessing heart failure (HF) severity and prognosis. Renal failure results in disproportionate increases of NT-proBNP and an increased NT-proBNP/BNP ratio. Low kidney function is therefore considered particularly when NT-proBNP is used to assess HF. The purpose of this study was to identify other conditions affecting the NT-proBNP/BNP ratio. We examined the NT-proBNP/BNP ratio, 26 other lab parameters, and clinical factors in 218 patients admitted to the HF ward. In addition to renal function, we also found significant correlations between the NT-proBNP/BNP ratio and inflammation as measured by orosomucoid (r = 0.525, p < 0.0001), CRP (r = 0.333, p < 0.0001), haptoglobulin (r = 0.201, p = 0.02), and alpha1-antitrypsin (r = 0.223, p = 0.01). Reverse correlation was found with transferrin (r = -0.323, p < 0.0001), albumin (r = -0.251, p = 0.003), and S-Fe (r = -0.205, p = 0.02), parameters known to decrease during inflammation. Inflammation increased levels of NT-proBNP more than BNP, resulting in an increased NT-proBNP/BNP ratio. Our findings indicate that NT-proBNP should be evaluated concomitantly with inflammatory status to avoid overestimation of HF severity.

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