NDLI: Influence of glycosylation on diagnostic and prognostic accuracy of N-terminal pro-B-type natriuretic peptide in acute dyspnea: data from the Akershus Cardiac Examination 2 Study.

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Influence of glycosylation on diagnostic and prognostic accuracy of N-terminal pro-B-type natriuretic peptide in acute dyspnea: data from the Akershus Cardiac Examination 2 Study.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Røsjø, Helge Dahl, Mai Britt Jørgensen, Marit Røysland, Ragnhild Brynildsen, Jon Cataliotti, Alessandro Christensen, Geir Høiseth, Arne Didrik Hagve, Tor-Arne Omland, Torbjørn
Description	Author Affiliation: Røsjø H ( Division of Medicine, Akershus University Hospital, Lørenskog, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Dahl MB ( Department of Clinical Molecular Biology, Akershus University Hospital, Lørenskog, Norway, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Jørgensen M ( Division of Medicine, Akershus University Hospital, Lørenskog, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Røysland R ( Division of Medicine, Akershus University Hospital, Lørenskog, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Brynildsen J ( Division of Medicine, Akershus University Hospital, Lørenskog, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Cataliotti A ( Institute for Experimental Medical Research, Oslo University Hospital, Ullevål, Oslo, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Christensen G ( Institute for Experimental Medical Research, Oslo University Hospital, Ullevål, Oslo, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Høiseth AD ( Division of Medicine, Akershus University Hospital, Lørenskog, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway); Hagve TA ( Section for Medical Biochemistry, Division for Diagnostics and Technology, Akershus University Hospital, Lørenskog, Norway, and Institute of Clinical Medicine, University of Oslo, Oslo, Norway.); Omland T ( Division of Medicine, Akershus University Hospital, Lørenskog, Norway, and Center for Heart Failure Research and K.G. Jebsen Cardiac Research Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway)
Abstract	BACKGROUND: The N-terminal part of pro-B-type natriuretic peptide (NT-proBNP) is glycosylated, but whether glycosylation influences the diagnostic and prognostic accuracy of NT-proBNP measurements is not known. METHODS: We measured NT-proBNP concentrations of 309 patients with acute dyspnea by use of standard EDTA tubes and EDTA tubes pretreated with deglycosylation enzymes. The primary cause of dyspnea was classified as heart failure (HF) or non-HF, and the diagnosis was adjudicated by 2 independent physicians. We collected information on all-cause mortality during follow-up. RESULTS: In all, 142 patients (46%) were diagnosed with HF. NT-proBNP concentrations in nondeglycosylated samples distinguished HF patients from patients with non-HF related dyspnea [median 3588 (quartiles 1-3 1578-8404) vs 360 (126-1139) ng/L, P < 0.001], but concentrations were markedly higher in samples pretreated with deglycosylation enzymes (total NT-proBNP) [7497 (3374-14 915) vs 798 (332-2296) ng/L, P < 0.001]. The AUC to separate HF patients from patients with non-HF related dyspnea was 0.871 (95% CI 0.829-0.907) for total NT-proBNP compared with 0.852 (0.807-0.890) for NT-proBNP measurements in standard EDTA plasma. During a median follow-up of 816 days, 112 patients (36%) died. Both NT-proBNP and total NT-proBNP concentrations were associated with mortality in separate multivariate models, but only total NT-proBNP concentrations provided added value to the basic risk model of our dataset as assessed by the net reclassification index: 0.24 (95% CI 0.003-0.384). There was a graded increase in risk across total NT-proBNP quartiles, in contrast with the results for NT-proBNP measurements. CONCLUSIONS: NT-proBNP concentrations were higher, and diagnostic and prognostic accuracy was improved, by pretreating tubes with deglycosylation enzymes.
File Format	HTM / HTML
ISSN	00099147
e-ISSN	15308561
Journal	Clinical Chemistry
Issue Number	8
Volume Number	61
Language	English
Publisher	American Association for Clinical Chemistry
Publisher Date	2015-08-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Research Support, Non-u.s. Gov't Peptide Fragments Prognosis Blood Chemical Analysis Area Under Curve Instrumentation Discipline Laboratory Medicine Predictive Value Of Tests Blood Dyspnea Natriuretic Peptide, Brain Etiology Heart Failure Diagnosis Clinical Trial Complications Mortality Glycosylation Metabolism Discipline Clinical Chemistry
Content Type	Text
Resource Type	Article
Subject	Biochemistry (medical) Clinical Biochemistry

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