N-terminal proatrial natriuretic factor: An independent predictor of long-term prognosis after myocardial infarction

Christian Hall, Jean L. Rouleau, Lemuel Moyè, Jacques De Champlain, Daniel Bichet, Marc Klein, Bruce Sussex, Milton Packer, Jacques Rouleau, Malcolm O. Arnold, Gervasio A. Lamas, Francois Sestier, Stephen S. Gottlieb, Chuan Chuan C Wun, Marc A. Pfeffer

Research output: Contribution to journalArticle

228 Citations (Scopus)

Abstract

Background: Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly. Methods and Results: To test the prognostic value of N-terminal proANF after myocardial infarction, its plasma concentration was measured a mean of 12 days after infarction in 246 patients in the Survival and Ventricular Enlargement (SAVE) Study. N-terminal proANF was a much stronger predictor of survival than ANF itself. Furthermore, in multivariate analysis of cardiovascular mortality and development of heart failure, N-terminal proANF in contrast to ANF and other neurohormones was still a powerful and independent predictor when the model included age, gender, prior myocardial infarction, hypertension, diabetes, use of thrombolysis, Killip class, infarct location, and LVEF. Conclusions: The measurement of N-terminal proANF supplements presently used clinical and objective assessments and provides an important independent predictor of prognosis with respect to cardiovascular mortality and development of heart failure.

Original languageEnglish (US)
Pages (from-to)1934-1942
Number of pages9
JournalCirculation
Volume89
Issue number5
StatePublished - May 1994

Fingerprint

Atrial Natriuretic Factor
Myocardial Infarction
Neurotransmitter Agents
Stroke Volume
Multivariate Analysis
Heart Failure
Atrial Pressure
Survival
Mortality
Peptide Hormones
Infarction
Half-Life
Hypertension

Keywords

  • Atrial natriuretic factor
  • Congestive heart failure
  • Myocardial infarction
  • Prognosis

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Hall, C., Rouleau, J. L., Moyè, L., De Champlain, J., Bichet, D., Klein, M., ... Pfeffer, M. A. (1994). N-terminal proatrial natriuretic factor: An independent predictor of long-term prognosis after myocardial infarction. Circulation, 89(5), 1934-1942.

N-terminal proatrial natriuretic factor : An independent predictor of long-term prognosis after myocardial infarction. / Hall, Christian; Rouleau, Jean L.; Moyè, Lemuel; De Champlain, Jacques; Bichet, Daniel; Klein, Marc; Sussex, Bruce; Packer, Milton; Rouleau, Jacques; Arnold, Malcolm O.; Lamas, Gervasio A.; Sestier, Francois; Gottlieb, Stephen S.; Wun, Chuan Chuan C; Pfeffer, Marc A.

In: Circulation, Vol. 89, No. 5, 05.1994, p. 1934-1942.

Research output: Contribution to journalArticle

Hall, C, Rouleau, JL, Moyè, L, De Champlain, J, Bichet, D, Klein, M, Sussex, B, Packer, M, Rouleau, J, Arnold, MO, Lamas, GA, Sestier, F, Gottlieb, SS, Wun, CCC & Pfeffer, MA 1994, 'N-terminal proatrial natriuretic factor: An independent predictor of long-term prognosis after myocardial infarction', Circulation, vol. 89, no. 5, pp. 1934-1942.
Hall C, Rouleau JL, Moyè L, De Champlain J, Bichet D, Klein M et al. N-terminal proatrial natriuretic factor: An independent predictor of long-term prognosis after myocardial infarction. Circulation. 1994 May;89(5):1934-1942.
Hall, Christian ; Rouleau, Jean L. ; Moyè, Lemuel ; De Champlain, Jacques ; Bichet, Daniel ; Klein, Marc ; Sussex, Bruce ; Packer, Milton ; Rouleau, Jacques ; Arnold, Malcolm O. ; Lamas, Gervasio A. ; Sestier, Francois ; Gottlieb, Stephen S. ; Wun, Chuan Chuan C ; Pfeffer, Marc A. / N-terminal proatrial natriuretic factor : An independent predictor of long-term prognosis after myocardial infarction. In: Circulation. 1994 ; Vol. 89, No. 5. pp. 1934-1942.
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title = "N-terminal proatrial natriuretic factor: An independent predictor of long-term prognosis after myocardial infarction",
abstract = "Background: Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly. Methods and Results: To test the prognostic value of N-terminal proANF after myocardial infarction, its plasma concentration was measured a mean of 12 days after infarction in 246 patients in the Survival and Ventricular Enlargement (SAVE) Study. N-terminal proANF was a much stronger predictor of survival than ANF itself. Furthermore, in multivariate analysis of cardiovascular mortality and development of heart failure, N-terminal proANF in contrast to ANF and other neurohormones was still a powerful and independent predictor when the model included age, gender, prior myocardial infarction, hypertension, diabetes, use of thrombolysis, Killip class, infarct location, and LVEF. Conclusions: The measurement of N-terminal proANF supplements presently used clinical and objective assessments and provides an important independent predictor of prognosis with respect to cardiovascular mortality and development of heart failure.",
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T2 - An independent predictor of long-term prognosis after myocardial infarction

AU - Hall, Christian

AU - Rouleau, Jean L.

AU - Moyè, Lemuel

AU - De Champlain, Jacques

AU - Bichet, Daniel

AU - Klein, Marc

AU - Sussex, Bruce

AU - Packer, Milton

AU - Rouleau, Jacques

AU - Arnold, Malcolm O.

AU - Lamas, Gervasio A.

AU - Sestier, Francois

AU - Gottlieb, Stephen S.

AU - Wun, Chuan Chuan C

AU - Pfeffer, Marc A.

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N2 - Background: Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly. Methods and Results: To test the prognostic value of N-terminal proANF after myocardial infarction, its plasma concentration was measured a mean of 12 days after infarction in 246 patients in the Survival and Ventricular Enlargement (SAVE) Study. N-terminal proANF was a much stronger predictor of survival than ANF itself. Furthermore, in multivariate analysis of cardiovascular mortality and development of heart failure, N-terminal proANF in contrast to ANF and other neurohormones was still a powerful and independent predictor when the model included age, gender, prior myocardial infarction, hypertension, diabetes, use of thrombolysis, Killip class, infarct location, and LVEF. Conclusions: The measurement of N-terminal proANF supplements presently used clinical and objective assessments and provides an important independent predictor of prognosis with respect to cardiovascular mortality and development of heart failure.

AB - Background: Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly. Methods and Results: To test the prognostic value of N-terminal proANF after myocardial infarction, its plasma concentration was measured a mean of 12 days after infarction in 246 patients in the Survival and Ventricular Enlargement (SAVE) Study. N-terminal proANF was a much stronger predictor of survival than ANF itself. Furthermore, in multivariate analysis of cardiovascular mortality and development of heart failure, N-terminal proANF in contrast to ANF and other neurohormones was still a powerful and independent predictor when the model included age, gender, prior myocardial infarction, hypertension, diabetes, use of thrombolysis, Killip class, infarct location, and LVEF. Conclusions: The measurement of N-terminal proANF supplements presently used clinical and objective assessments and provides an important independent predictor of prognosis with respect to cardiovascular mortality and development of heart failure.

KW - Atrial natriuretic factor

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