Association of N-Terminal Pro Brain Natriuretic Peptide and Long-Term Outcome in Patients With Pulmonary Arterial Hypertension

What Was Tested

The paper reports a study of BNP (Nesiritide), published as a randomized controlled trial.

The GRIPHON trial (Prostacyclin [PGI2] Receptor Agonist In Pulmonary Arterial Hypertension) provides an opportunity to assess the prognostic value of NT-proBNP thresholds in a controlled clinical trial and to evaluate the response to selexipag according to these thresholds.

Why It Was Studied

NT-proBNP (N-terminal pro brain natriuretic peptide) levels are included in the multiparametric risk assessment approach for pulmonary arterial hypertension (PAH) outlined in PAH guidelines.

However, data supporting the use of NT-proBNP risk thresholds in assessing prognosis in PAH are limited.

Who Took Part

The age groups tagged for this paper are teenagers, young adults, adults, middle-aged adults and older adults, both men and women.

The event-driven GRIPHON trial randomly assigned patients to selexipag or placebo.

Here, patients were categorized post hoc into low, medium, and high NT-proBNP subgroups according to 2 independent sets of thresholds: (1) baseline tertiles: <271 ng/L; 271 to 1165 ng/L; >1165 ng/L; and (2) 2015 European Society of Cardiology/European Respiratory Society guidelines cutoffs: <300 ng/L; 300 to 1400 ng/L; >1400 ng/L.

How the Study Was Run

In design terms this was a randomized, double-blind and placebo-controlled study.

Because people in this BNP (Nesiritide) study were split into groups at random, differences between the groups are less likely to reflect who happened to join each one.

As a double-blind BNP (Nesiritide) study, the assignments were hidden from both participants and investigators until the end.

The comparison arm used a placebo, so changes seen with BNP (Nesiritide) could be set against what happens without it.

NT-proBNP was measured at regular intervals in GRIPHON.

What Was Measured

NT-proBNP (N-terminal pro brain natriuretic peptide) levels are included in the multiparametric risk assessment approach for pulmonary arterial hypertension (PAH) outlined in PAH guidelines.

However, data supporting the use of NT-proBNP risk thresholds in assessing prognosis in PAH are limited.

PubMed files the paper under topics including Acetamides, Antihypertensive Agents, Arterial Pressure, Biomarkers, Natriuretic Peptide, Brain, Peptide Fragments and Pulmonary Arterial Hypertension.

Author keywords: brain natriuretic peptide, hypertension, pulmonary, prostacyclin receptor and risk assessment.

What This Means in Plain Language

The paper is a randomized, double-blind and placebo-controlled study of BNP (Nesiritide).

Results are reported in around 5 sentences of the abstract; we leave them to the paper itself rather than summarise them.

The publication is from 2019 (Circulation), a journal based in United States.

More context: the BNP (Nesiritide) compound page, all human trials.