Can measurement of B-type natriuretic peptide levels improve cardiovascular disease prevention?
Can measurement of B-type natriuretic peptide levels improve cardiovascular disease prevention?
复制标题
DOI：
10.1111/j.1440-1681.2008.04894.x
复制
发表时间：
2008-04-01
影响因子：
2.9
通讯作者：
Campbell, Duncan J.
中科院分区：
文献类型：
--
作者：
Campbell, Duncan J.
1.血浆B型利钠肽(BNP)和氨基端BNP原(NT-proBNP)水平的测定对可疑心力衰竭患者提供了有用的诊断信息，对心力衰竭、急性冠脉综合征、瓣膜性心脏病和其他心脏疾病患者的预后提供了有价值的信息。BNP和NT-proBNP引导的心力衰竭治疗改善了患者的预后。越来越多的研究表明，在有或没有已知心血管疾病的稳定患者中，血浆BNP和NT-proBNP水平可以预测全因死亡率和心血管事件，包括心力衰竭、心肌梗死、中风、心房颤动和心血管死亡，并提供传统危险因素提供的心血管风险信息。降压治疗降低心血管风险增加个体升高的NT-proBNP水平，从而提示NT-proBNP水平的改变提供了一种降低风险的措施。因此，对BNP和NT-proBNP水平的监测提供了改善针对心血管风险增加的个体的目标的可能性，并优化了心血管疾病的一级和二级预防策略。需要一项结果研究来确定BNP或NT-proBNP引导的治疗是否能改善心血管疾病的预防。
1. The measurement of plasma levels of B-type natriuretic peptide (BNP) and amino-terminal pro-BNP (NT-proBNP) provides useful diagnostic information in patients with suspected heart failure and valuable prognostic information in patients with heart failure, acute coronary syndrome, valvular heart disease and other cardiac pathologies.2. BNP- and NT-proBNP-guided heart failure therapy improves patient outcomes.3. An increasing number of studies shows plasma BNP and NT-proBNP levels predict all-cause mortality and cardiovascular events including heart failure, myocardial infarction, stroke, atrial fibrillation and cardiovascular death in stable patients with or without known cardiovascular disease and provide information about cardiovascular risk additional to that provided by traditional risk factors.4. Anti hypertensive therapy reduces elevated NT-proBNP levels in individuals at increased cardiovascular risk, thereby suggesting that change in NT-proBNP levels provides a measure of risk reduction.5. Thus, monitoring of BNP and NT-proBNP levels offers the possibilities of improved targeting of individuals with increased cardiovascular risk and optimization of strategies for primary and secondary prevention of cardiovascular disease.6. There is need for an outcome study to determine whether BNP- or NT-proBNP-guided therapy improves cardiovascular disease prevention.