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

Journal article
Authors Juliana Jensen
Li-Ping Ma
Michael Fu
David Svaninger
Per-Arne Lundberg
Ola Hammarsten
Published in Clinical research in cardiology : official journal of the German Cardiac Society
Volume 99
Issue 7
Pages 445-452
ISSN 1861-0692
Publication year 2010
Published at Department of Chemistry
Institute of Biomedicine, Department of Clinical Chemistry and Transfusion Medicine
Institute of Biomedicine
Institute of Medicine
Pages 445-452
Language en
Links dx.doi.org/10.1007/s00392-010-0140-...
Keywords 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
Subject categories Chemistry

Abstract

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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