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Hormones Predict Outcomes After Heart Attack

High levels of two peptides predict adverse outcomes

THURSDAY, May 8 (HealthDay News) -- High levels of two peptide hormones are strong predictors of adverse outcomes after a heart attack, according to an article published in the May 13 issue of the Journal of the American College of Cardiology.

Sohail Q. Khan, from the University of Leicester in the United Kingdom, and colleagues compared the prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP), an established marker, and midregional proatrial natriuretic peptide (MR-proANP), a newly described marker, in 983 consecutive patients after acute myocardial infarction.

After a median follow-up of 343 days, there were 101 deaths. The investigators found that high log10 values of both markers were significant independent predictors of death (hazard ratio 3.87 for MR-proANP and 3.25 for NT-proBNP). Patients in the highest quartile of NT-proBNP levels who were also in the top quartile of MR-proANP levels had significantly poorer outcomes, they report. Similar results were found for heart failure, although neither marker could predict recurrent myocardial infarction.

"Midregional proatrial natriuretic peptide is a powerful predictor of adverse outcome, especially in those with an elevated NT-proBNP," Khan and colleagues conclude. "Midregional proatrial natriuretic peptide may represent a clinically useful marker of prognosis after an acute myocardial infarction as part of a multimarker strategy targeting the natriuretic neurohormonal pathway."

Several authors are employees of BRAHMS Aktiengesellschaft in Henningsdorf, Germany.

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