Evidence map›Paper›PMID 34246604›Full record

ArticleJACC. Heart failure2021

Prognostic Value of Urinary and Plasma C-Type Natriuretic Peptide in Acute Decompensated Heart Failure.

Xiao Ma, Yang Chen, Shawn H Reginauld, Christopher G Scott, Seethalakshmi R Iyer, Jacob J Schaefer, Tomoko Ichiki, Horng H Chen, Andrew D Rule, John C Burnett and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in JACC. Heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Xiao MaCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: Ma.Xiao@mayo.edu.
Yang ChenCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Shawn H ReginauldCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Christopher G ScottDivision of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA.
Seethalakshmi R IyerCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Jacob J SchaeferCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Tomoko IchikiCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Department of Cardiology, International University of Health and Welfare, Narita, Japan.
Horng H ChenCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Andrew D RuleDivision of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA.
John C BurnettCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA.
S Jeson SangaralinghamCardiorenal Research Laboratory, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA. Electronic address: Sangaralingham.Jeson@mayo.edu.

Funding

INTRARENAL REGULATION OF SODIUM EXCRETIONR01HL036634 · NHLBI · MAYO CLINIC ROCHESTER · PI BURNETT, JOHN C · 1987 to 2019
$6.5M
Cardiorenal Fibrosis: Biology and TherapeuticsR01HL132854 · NHLBI · MAYO CLINIC ROCHESTER · PI SANGARALINGHAM, SASANTHA JESON · 2016 to 2020
$2.0M
NHLBI NIH HHS R01 HL036634NHLBI NIH HHS R01 HL132854
6 · The paper itself

Abstract

objectivesThis study sought to characterize urinary and plasma C-type natriuretic peptide (CNP) in acute decompensated heart failure (ADHF) to define their relationship with clinical variables and to determine whether urinary and plasma CNP together add prognostic value.

backgroundCNP is a protective hormone that is synthesized in the kidney and endothelium and possesses antiremodeling properties. Urinary and plasma CNP levels are elevated in pathophysiological conditions; however, their regulation and prognostic value in heart failure (HF) is unclear.

methodsUrinary and plasma CNP were measured in 109 healthy subjects and 208 patients with ADHF; the 95th percentile of CNP values from healthy subjects established the normal contemporary cutoffs. Patients with ADHF were stratified based on urinary and plasma CNP levels for clinical characterization and the assessment of risk for adverse outcomes.

resultsThere was no significant correlation between urinary and plasma CNP in both cohorts. Urinary and plasma CNP were significantly elevated in patients with ADHF, and both increased with disease severity and were positively correlated with plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP). Of the patients with ADHF, 23% had elevations in both urinary and plasma CNP, whereas 24% had normal CNP levels. During a median follow-up of 3 years, patients with elevated urinary and plasma CNP had a significantly higher risk of rehospitalization and/or death (HR: 1.79; P = 0.03) and rehospitalization (HR: 2.16; P = 0.01) after adjusting for age, sex, left ventricular ejection fraction, renal function, and plasma NT-proBNP. The C-statistic and integrated discrimination analyses further supported that the addition of urinary and plasma CNP to established risk models improved the prediction of adverse outcomes in patients with ADHF.

conclusionsUrinary and plasma CNP are differentially regulated in ADHF, and elevations in both provided independent prognostic value for predicting adverse outcomes.

Indexed as

Heart FailureNatriuretic Peptide, C-TypeAcute DiseaseBiomarkersHumansNatriuretic Peptide, BrainPeptide FragmentsPrognosisStroke VolumeVentricular Function, LeftBiomarkersNatriuretic Peptide, BrainNatriuretic Peptide, C-TypePeptide Fragmentspro-brain natriuretic peptide (1-76)acute decompensated heart failureC-type natriuretic peptideplasmaprognosisrehospitalizationurinary

Identifiers

PMID34246604
PMCPMC8419026

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

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.