Observational studyBMC medicine2019
B-type natriuretic peptide trumps other prognostic markers in patients assessed for coronary disease.
Observational study in BMC medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00403351 (Correlation of Multiple Risk Factors With Presence and Severity of Coronary Artery Disease.), which is not on this map. Cited by 11 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Correlation of Multiple Risk Factors With Presence and Severity of Coronary Artery Disease.
Who cites it
11 citing papers in PubMed, 27 citations in OpenAlex.
- Trial
- Utilizing natriuretic peptides for predicting heart failure risk following myocardial infarction.Cardiovascular endocrinology & metabolism · 2025Article
- A systematic comparison of short-term and long-term mortality prediction in acute myocardial infarction using machine learning models.BMC medical informatics and decision making · 2025Observational
- Association Between First-Phase Left Ventricular Ejection Fraction and Severity of Coronary Artery Stenosis and Changes With Interventional Treatment.Journal of the American Heart Association · 2025Article
- Correlation of blood lipids, glucose, and inflammatory indices with the occurrence and prognosis of lesion complexity in unstable angina, a retrospective cohort study.Journal of thoracic disease · 2025Article
- Association Between Fibrinogen-to-Albumin Ratio and Long-Term Mortality in Senile Patients with Coronary Artery Disease: A Prospective 10-Year Follow-up Study.Clinical interventions in aging · 2025Article
- Using the Super Learner algorithm to predict risk of major adverse cardiovascular events after percutaneous coronary intervention in patients with myocardial infarction.BMC medical research methodology · 2024Article
- Post-mortem examination of high mortality in patients with heart failure and atrial fibrillation.BMC medicine · 2022Article
- The Expression Significance of LPa, BNP, and McP-1 in CHD Patients and Their Relationship with Echocardiographic Parameters.Contrast media & molecular imaging · 2022Article
- Improving the diagnosis of heart failure in patients with atrial fibrillation.Heart (British Cardiac Society) · 2021Article
- The age, NT-proBNP, and Ejection Fraction Score as a Novel Predictor of Clinical Outcomes in CAD Patients After PCI.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/HemostasisObservational
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 6 institutions in 3 countries.
Funding
Abstract
backgroundRisk prediction for patients with suspected coronary artery disease is complex due to the common occurrence of prior cardiovascular disease and extensive risk modification in primary care. Numerous markers have the potential to predict prognosis and guide management, but we currently lack robust 'real-world' evidence for their use.
methodsProspective, multicentre observational study of consecutive patients referred for elective coronary angiography. Clinicians were blinded to all risk assessments, consisting of conventional factors, radial artery pulse wave analysis, 5-minute heart rate variability, high-sensitivity C-reactive protein and B-type natriuretic peptide (BNP). Blinded, independent adjudication was performed for all-cause mortality and the composite of death, myocardial infarction or stroke, analysed with Cox proportional hazards regression.
resultsFive hundred twenty-two patients were assessed with median age 66 years and 21% prior revascularization. Median baseline left ventricular ejection fraction was 64%, and 62% had ≥ 50% stenosis on angiography. During 5.0 years median follow-up, 30% underwent percutaneous and 16% surgical revascularization. In multivariate analysis, only age and BNP were independently associated with outcomes. The adjusted hazard ratio per log unit increase in BNP was 2.15 for mortality (95% CI 1.45-3.19; p = 0.0001) and 1.27 for composite events (1.04-1.54; p = 0.018). Patients with baseline BNP > 100 pg/mL had substantially higher mortality and composite events (20.9% and 32.2%) than those with BNP ≤ 100 pg/mL (5.6% and 15.5%). BNP improved both classification and discrimination of outcomes (p ≤ 0.003), regardless of left ventricular systolic function. Conversely, high-sensitivity C-reactive protein, pulse wave analysis and heart rate variability were unrelated to prognosis at 5 years after risk modification and treatment of coronary disease.
conclusionsConventional risk factors and other markers of arterial compliance, inflammation and autonomic function have limited value for prediction of outcomes in risk-modified patients assessed for coronary disease. BNP can independently identify patients with subtle impairment of cardiac function that might benefit from more intensive management.
trial registrationClinicaltrials.gov, NCT00403351 Registered on 22 November 2006.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.