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Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure trial (Val-HeFT)
Neurohormones are considered markers of heart failure progression. We examined whether changes in brain natriuretic peptide (BNP) and norepinephrine (NE) over time are associated with corresponding changes in mortality and morbidity in the Valsartan Heart Failure Trial. Plasma BNP and NE were measur...
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Published in: | Circulation (New York, N.Y.) N.Y.), 2003-03, Vol.107 (9), p.1278-1283 |
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container_title | Circulation (New York, N.Y.) |
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creator | ANAND, Inder S FISHER, Lloyd D CHIANG, Yann-Tong LATINI, Roberto MASSON, Serge MAGGIONI, Aldo P GLAZER, Robert D TOGNONI, Gianni COHN, Jay N |
description | Neurohormones are considered markers of heart failure progression. We examined whether changes in brain natriuretic peptide (BNP) and norepinephrine (NE) over time are associated with corresponding changes in mortality and morbidity in the Valsartan Heart Failure Trial.
Plasma BNP and NE were measured before randomization and during follow-up in approximately 4300 patients in the Valsartan Heart Failure Trial. The relation between baseline BNP and NE and all-cause mortality and first morbid event (M&M) was analyzed in subgroups, with values above and below the median, and by quartiles. The change and percent change from baseline to 4 and 12 months in BNP and NE were also analyzed by quartiles for subsequent M&M. Risk ratios for M&M were calculated using a Cox proportional hazard model. Risk ratio of M&M for patients with baseline BNP or NE above the median was significantly higher than that for patients with values below the median. Baseline BNP and NE in quartiles also showed a quartile-dependent increase in M&M. BNP had a stronger association with M&M than NE. Patients with the greatest percent decrease in BNP and NE from baseline to 4 and 12 months had the lowest whereas patients with greatest percent increase in BNP and NE had the highest M&M.
Not only are plasma BNP and NE important predictors of heart failure M&M, but changes in these neurohormones over time are associated with corresponding changes in M&M. These data further reinforce their role as significant surrogate markers in HF and underscore the importance of including their measurement in HF trials. |
doi_str_mv | 10.1161/01.cir.0000054164.99881.00 |
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Plasma BNP and NE were measured before randomization and during follow-up in approximately 4300 patients in the Valsartan Heart Failure Trial. The relation between baseline BNP and NE and all-cause mortality and first morbid event (M&M) was analyzed in subgroups, with values above and below the median, and by quartiles. The change and percent change from baseline to 4 and 12 months in BNP and NE were also analyzed by quartiles for subsequent M&M. Risk ratios for M&M were calculated using a Cox proportional hazard model. Risk ratio of M&M for patients with baseline BNP or NE above the median was significantly higher than that for patients with values below the median. Baseline BNP and NE in quartiles also showed a quartile-dependent increase in M&M. BNP had a stronger association with M&M than NE. Patients with the greatest percent decrease in BNP and NE from baseline to 4 and 12 months had the lowest whereas patients with greatest percent increase in BNP and NE had the highest M&M.
Not only are plasma BNP and NE important predictors of heart failure M&M, but changes in these neurohormones over time are associated with corresponding changes in M&M. These data further reinforce their role as significant surrogate markers in HF and underscore the importance of including their measurement in HF trials.]]></description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.0000054164.99881.00</identifier><identifier>PMID: 12628948</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Antihypertensive agents ; Biological and medical sciences ; Biomarkers - blood ; Cardiovascular system ; Double-Blind Method ; Follow-Up Studies ; Heart Failure - blood ; Heart Failure - drug therapy ; Heart Failure - mortality ; Humans ; Kinetics ; Medical sciences ; Natriuretic Peptide, Brain - blood ; Norepinephrine - blood ; Pharmacology. Drug treatments ; Prognosis ; Survival Analysis ; Tetrazoles - therapeutic use ; Valine - analogs & derivatives ; Valine - therapeutic use ; Valsartan</subject><ispartof>Circulation (New York, N.Y.), 2003-03, Vol.107 (9), p.1278-1283</ispartof><rights>2003 INIST-CNRS</rights><rights>Copyright American Heart Association, Inc. Mar 11 2003</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c589t-ed1dda13f60dda8740ef11ea8af74bbd67a0f346bd5d80675b7d9b9b4e53effd3</citedby><cites>FETCH-LOGICAL-c589t-ed1dda13f60dda8740ef11ea8af74bbd67a0f346bd5d80675b7d9b9b4e53effd3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=14617204$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/12628948$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>ANAND, Inder S</creatorcontrib><creatorcontrib>FISHER, Lloyd D</creatorcontrib><creatorcontrib>CHIANG, Yann-Tong</creatorcontrib><creatorcontrib>LATINI, Roberto</creatorcontrib><creatorcontrib>MASSON, Serge</creatorcontrib><creatorcontrib>MAGGIONI, Aldo P</creatorcontrib><creatorcontrib>GLAZER, Robert D</creatorcontrib><creatorcontrib>TOGNONI, Gianni</creatorcontrib><creatorcontrib>COHN, Jay N</creatorcontrib><creatorcontrib>Val-HeFT Investigators</creatorcontrib><title>Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure trial (Val-HeFT)</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description><![CDATA[Neurohormones are considered markers of heart failure progression. We examined whether changes in brain natriuretic peptide (BNP) and norepinephrine (NE) over time are associated with corresponding changes in mortality and morbidity in the Valsartan Heart Failure Trial.
Plasma BNP and NE were measured before randomization and during follow-up in approximately 4300 patients in the Valsartan Heart Failure Trial. The relation between baseline BNP and NE and all-cause mortality and first morbid event (M&M) was analyzed in subgroups, with values above and below the median, and by quartiles. The change and percent change from baseline to 4 and 12 months in BNP and NE were also analyzed by quartiles for subsequent M&M. Risk ratios for M&M were calculated using a Cox proportional hazard model. Risk ratio of M&M for patients with baseline BNP or NE above the median was significantly higher than that for patients with values below the median. Baseline BNP and NE in quartiles also showed a quartile-dependent increase in M&M. BNP had a stronger association with M&M than NE. Patients with the greatest percent decrease in BNP and NE from baseline to 4 and 12 months had the lowest whereas patients with greatest percent increase in BNP and NE had the highest M&M.
Not only are plasma BNP and NE important predictors of heart failure M&M, but changes in these neurohormones over time are associated with corresponding changes in M&M. These data further reinforce their role as significant surrogate markers in HF and underscore the importance of including their measurement in HF trials.]]></description><subject>Antihypertensive agents</subject><subject>Biological and medical sciences</subject><subject>Biomarkers - blood</subject><subject>Cardiovascular system</subject><subject>Double-Blind Method</subject><subject>Follow-Up Studies</subject><subject>Heart Failure - blood</subject><subject>Heart Failure - drug therapy</subject><subject>Heart Failure - mortality</subject><subject>Humans</subject><subject>Kinetics</subject><subject>Medical sciences</subject><subject>Natriuretic Peptide, Brain - blood</subject><subject>Norepinephrine - blood</subject><subject>Pharmacology. Drug treatments</subject><subject>Prognosis</subject><subject>Survival Analysis</subject><subject>Tetrazoles - therapeutic use</subject><subject>Valine - analogs & derivatives</subject><subject>Valine - therapeutic use</subject><subject>Valsartan</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2003</creationdate><recordtype>article</recordtype><recordid>eNpdkW2L1DAQx4Mo3nr6FSQcKOeLrkmbp947WW7dgwNBTt-GtJm6Odq0Jq1wH8Lv7Ky7smBezDAzv3kgf0KuOFtzrvhHxtdtSGt2eFJwJdZ1bQzHxDOy4rIUhZBV_ZyssF4XuirLC_Iq50cMVaXlS3LBS1WaWpgV-b3Zu_gDMg2RNsmhjW5OYUkwh5ZOMM3BA3XR0zgmmEKEaZ_Q0vEXJDqH4VgcxjS7PsxP_6Im-EOE8-Y90O-uzw6JSHeAnm5d6HEFxU2up9dYLnawffjwmrzoEIU3J39Jvm1vHza74v7L57vNp_uilaaeC_Dce8erTjH0RgsGHefgjOu0aBqvtGNdJVTjpTdMadloXzd1I0BW0HW-uiTvj3OnNP5cIM92CLmFvncRxiVbXbHaKCUQvPoPfByXFPE2W-InIiI5QjdHqE1jzgk6O6UwuPRkObMHxSzjdnP31Z4Vs38VwwQ2vz1tWJoB_Ln1JBEC706Ay63ru-RiG_KZE4rrkonqD1-lobY</recordid><startdate>20030311</startdate><enddate>20030311</enddate><creator>ANAND, Inder S</creator><creator>FISHER, Lloyd D</creator><creator>CHIANG, Yann-Tong</creator><creator>LATINI, Roberto</creator><creator>MASSON, Serge</creator><creator>MAGGIONI, Aldo P</creator><creator>GLAZER, Robert D</creator><creator>TOGNONI, Gianni</creator><creator>COHN, Jay N</creator><general>Lippincott Williams & Wilkins</general><general>American Heart Association, Inc</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20030311</creationdate><title>Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure trial (Val-HeFT)</title><author>ANAND, Inder S ; FISHER, Lloyd D ; CHIANG, Yann-Tong ; LATINI, Roberto ; MASSON, Serge ; MAGGIONI, Aldo P ; GLAZER, Robert D ; TOGNONI, Gianni ; COHN, Jay N</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c589t-ed1dda13f60dda8740ef11ea8af74bbd67a0f346bd5d80675b7d9b9b4e53effd3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2003</creationdate><topic>Antihypertensive agents</topic><topic>Biological and medical sciences</topic><topic>Biomarkers - blood</topic><topic>Cardiovascular system</topic><topic>Double-Blind Method</topic><topic>Follow-Up Studies</topic><topic>Heart Failure - blood</topic><topic>Heart Failure - drug therapy</topic><topic>Heart Failure - mortality</topic><topic>Humans</topic><topic>Kinetics</topic><topic>Medical sciences</topic><topic>Natriuretic Peptide, Brain - blood</topic><topic>Norepinephrine - blood</topic><topic>Pharmacology. Drug treatments</topic><topic>Prognosis</topic><topic>Survival Analysis</topic><topic>Tetrazoles - therapeutic use</topic><topic>Valine - analogs & derivatives</topic><topic>Valine - therapeutic use</topic><topic>Valsartan</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>ANAND, Inder S</creatorcontrib><creatorcontrib>FISHER, Lloyd D</creatorcontrib><creatorcontrib>CHIANG, Yann-Tong</creatorcontrib><creatorcontrib>LATINI, Roberto</creatorcontrib><creatorcontrib>MASSON, Serge</creatorcontrib><creatorcontrib>MAGGIONI, Aldo P</creatorcontrib><creatorcontrib>GLAZER, Robert D</creatorcontrib><creatorcontrib>TOGNONI, Gianni</creatorcontrib><creatorcontrib>COHN, Jay N</creatorcontrib><creatorcontrib>Val-HeFT Investigators</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>ANAND, Inder S</au><au>FISHER, Lloyd D</au><au>CHIANG, Yann-Tong</au><au>LATINI, Roberto</au><au>MASSON, Serge</au><au>MAGGIONI, Aldo P</au><au>GLAZER, Robert D</au><au>TOGNONI, Gianni</au><au>COHN, Jay N</au><aucorp>Val-HeFT Investigators</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure trial (Val-HeFT)</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>2003-03-11</date><risdate>2003</risdate><volume>107</volume><issue>9</issue><spage>1278</spage><epage>1283</epage><pages>1278-1283</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract><![CDATA[Neurohormones are considered markers of heart failure progression. We examined whether changes in brain natriuretic peptide (BNP) and norepinephrine (NE) over time are associated with corresponding changes in mortality and morbidity in the Valsartan Heart Failure Trial.
Plasma BNP and NE were measured before randomization and during follow-up in approximately 4300 patients in the Valsartan Heart Failure Trial. The relation between baseline BNP and NE and all-cause mortality and first morbid event (M&M) was analyzed in subgroups, with values above and below the median, and by quartiles. The change and percent change from baseline to 4 and 12 months in BNP and NE were also analyzed by quartiles for subsequent M&M. Risk ratios for M&M were calculated using a Cox proportional hazard model. Risk ratio of M&M for patients with baseline BNP or NE above the median was significantly higher than that for patients with values below the median. Baseline BNP and NE in quartiles also showed a quartile-dependent increase in M&M. BNP had a stronger association with M&M than NE. Patients with the greatest percent decrease in BNP and NE from baseline to 4 and 12 months had the lowest whereas patients with greatest percent increase in BNP and NE had the highest M&M.
Not only are plasma BNP and NE important predictors of heart failure M&M, but changes in these neurohormones over time are associated with corresponding changes in M&M. These data further reinforce their role as significant surrogate markers in HF and underscore the importance of including their measurement in HF trials.]]></abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>12628948</pmid><doi>10.1161/01.cir.0000054164.99881.00</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Antihypertensive agents Biological and medical sciences Biomarkers - blood Cardiovascular system Double-Blind Method Follow-Up Studies Heart Failure - blood Heart Failure - drug therapy Heart Failure - mortality Humans Kinetics Medical sciences Natriuretic Peptide, Brain - blood Norepinephrine - blood Pharmacology. Drug treatments Prognosis Survival Analysis Tetrazoles - therapeutic use Valine - analogs & derivatives Valine - therapeutic use Valsartan |
title | Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure trial (Val-HeFT) |
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