Key result
Anemia linked to ~7-fold greater odds of elevated BNP in CAD patients.
Why the study?
Whether the association of anemia with elevated plasma levels of BNP and ANP is mediated by hemodynamic effects of anemia was unknown.
Does anemia predict elevated natriuretic peptide levels in patients undergoing cardiac catheterization for coronary artery disease?
Cross-Sectional (n=237)
No
Does anemia predict elevated natriuretic peptide levels in patients undergoing cardiac catheterization for coronary artery disease?
Odds Ratio: 7.39 (95% CI 2.76–19.8)
p-value: p=<0.001
Anemia is an independent predictor of elevated BNP and ANP levels in patients with CAD, independent of hemodynamic effects.
May warrant caution interpreting BNP in anemic CAD; leaves open causal effects on levels or outcomes.
BACKGROUND: It is unknown whether the association of anemia with elevated plasma levels of B-type and atrial natriuretic peptides (BNP and ANP) is mediated by the hemodynamic effects of anemia. METHODS AND RESULTS: The study group comprised 237 consecutive patients (BNP, median [interquartile range], 28.3 [9.5-77.1] pg/ml; ANP, 17.8 [8.5-39.0] pg/ml) undergoing determination of hemoglobin (Hb) and natriuretic peptide levels and cardiac catheterization for evaluation of coronary artery disease (CAD). Hb correlated with BNP (r=-0.36, p<0.001) and ANP (r=-0.35, p<0.001). Patients with anemia (Hb <12 g/dl for females; <13 g/dl for males, n=63) were more likely to be older with reduced body mass index and renal function, greater severity of CAD and to have higher heart rate, mean pulmonary capillary wedge pressure, and cardiac output. Anemia was a significant predictor for elevated (>third quartile value) natriuretic peptide levels and the predictive value remained significant after adjustment for other predictors, including increased left ventricular end-diastolic pressure and differences in clinical and hemodynamic variables between patients with and without anemia (adjusted odds ratio [95% confidence interval] for elevated BNP and ANP levels, 7.39 [2.76-19.8] and 2.56 [1.08-6.07], respectively). CONCLUSION: Anemia is an independent predictor for elevated natriuretic peptide levels in patients with known or suspected CAD.
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Fukuta et al. (2008) conducted a cross-sectional in Coronary artery disease (n=237). Anemia vs. No anemia was evaluated on Elevated plasma B-type natriuretic peptide (BNP) levels (>77.1 pg/ml) (OR 7.39, 95% CI 2.76-19.8, p=<0.001). Anemia was a significant independent predictor for elevated plasma B-type natriuretic peptide levels (adjusted OR 7.39) in patients undergoing cardiac catheterization for coronary artery disease.