Evidence map›Paper›PMID 34716603›Full record

ArticleClinical cardiology2021

Proenkephalin and the risk of new-onset heart failure: data from prevention of renal and vascular end-stage disease.

Johanna E Emmens, Jozine M Ter Maaten, Frank P Brouwers, Lyanne M Kieneker, Kevin Damman, Oliver Hartmann, Janin Schulte, Stephan J L Bakker, Rudolf A de Boer, Adriaan A Voors

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical cardiology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
0.6field-weighted citation impact, top 38% of its field
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

7 citing papers in PubMed, 11 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 2 institutions in 1 country.

Johanna E EmmensDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.ORCID https://orcid.org/0000-0001-9217-956X
Jozine M Ter MaatenDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Frank P BrouwersDepartment of Cardiology, Haga Teaching Hospital, The Hague, The Netherlands.
Lyanne M KienekerDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Kevin DammanDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Oliver HartmannSphingoTec GmbH, Hennigsdorf, Germany.
Janin SchulteSphingoTec GmbH, Hennigsdorf, Germany.
Stephan J L BakkerDepartment of Internal Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Rudolf A de BoerDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Adriaan A VoorsDepartment of Cardiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
University Medical Center Groningen · NLHaga Hospital · NL

Funding

Dutch Kidney Foundation E0.13
6 · The paper itself

Abstract

backgroundEnkephalins of the opioid system exert several cardiorenal effects. Proenkephalin (PENK), a stable surrogate, is associated with heart failure (HF) development after myocardial infarction and worse cardiorenal function and prognosis in patients with HF. The association between plasma PENK concentrations and new-onset HF in the general population remains to be established. HYPOTHESIS: We hypothesized that plasma PENK concentrations are associated with new-onset HF in the general population.

methodsWe included 6677 participants from the prevention of renal and vascular end-stage disease study and investigated determinants of PENK concentrations and their association with new-onset HF (both reduced [HFrEF] and preserved ejection fraction [HFpEF]).

resultsMedian PENK concentrations were 52.7 (45.1-61.9) pmol/L. Higher PENK concentrations were associated with poorer renal function and higher NT-proBNP concentrations. The main determinants of higher PENK concentrations were lower estimated glomerular filtration rate (eGFR), lower urinary creatinine excretion, and lower body mass index (all p < .001). After a median 8.3 (7.8-8.8) years follow-up, 221 participants developed HF; 127 HFrEF and 94 HFpEF. PENK concentrations were higher in subjects who developed HF compared with those who did not, 56.2 (45.2-67.6) versus 52.7 (45.1-61.6) pmol/L, respectively (p = .003). In competing-risk analyses, higher PENK concentrations were associated with higher risk of new-onset HF (hazard ratio [HR] = 2.09[1.47-2.97], p < .001), including both HFrEF (HR = 2.31[1.48-3.61], p < .001) and HFpEF (HR = 1.74[1.02-2.96], p = .042). These associations were, however, lost after adjustment for eGFR.

conclusionsIn the general population, higher PENK concentrations were associated with lower eGFR and higher NT-proBNP concentrations. Higher PENK concentrations were not independently associated with new-onset HFrEF and HFpEF and mainly confounded by eGFR.

Indexed as

Heart FailureEnkephalinsHumansKidneyPrognosisProtein PrecursorsStroke VolumeEnkephalinsproenkephalinProtein Precursorsenkephalinsglomerular filtration rateheart failureNT-proBNPproenkephalin

Identifiers

PMID34716603
PMCPMC8715404
OpenAlexW3208372913

What OpenQuestion holds

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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.