The following is the summary of “Urine N-terminal pro-B-type natriuretic peptide and plasma proenkephalin are promising biomarkers for early diagnosis of cardiorenal syndrome type 1 in acute decompensated heart failure: a prospective, double-center, observational study in real-world” published in the December 2022 issue of Renal failure by  Zhao, et al.

Cardiorenal syndrome type 1 (CRS-1) is associated with a worse prognosis for patients with acute decompensated heart failure (ADHF). However, a proper diagnosis of CRS-1 is sometimes delayed due to the present criteria. As a result, researchers analyzed the value of plasma proenkephalin (pPENK) and urine NT-proBNP (uNT-proBNP) in predicting CRS-1 and vulnerable-phase prognosis in ADHF patients. On admission, 121 patients with ADHF had their plasma NT-proBNP (pNT-proBNP), pPENK, and uNT-proBNP levels tested. Reference was set at pNGAL, or plasma neutrophil gelatinase-associated lipocalin. CRS-1 predictors were identified through the use of logistic regression. 

To evaluate the early diagnostic value of pNGAL, pPENK, and uNT-proBNP/uCr for CRS-1, the area under the receiver operating curves (ROCs) was computed. The Cox regression was carried out, and a cumulative risk curve was drawn to assess the prognostic risk factors for the 90-d outcomes of all ADHF patients. CRS-1 was independently predicted by pPENK [OR 1.093 (95% CI 1.022-1.169), P=0.010; AUROC=0.899 (95% CI 0.831-0.946)] and uNT-proBNP/uCr ratio [OR 1.015 (95% CI 1.003-1.028), P=0.012; AUROC=0.934 (95% CI 0.874-0.971)]. 

Independent predictors of HF readmission or all-cause death 90 d after discharge in ADHF patients included pPENK [HR 1.014 (95% CI 1.000-1.042), P=0.044] and uNT-proBNP/uCr ration [HR 0.998 (95% CI 0.997-1.000), P=0.045]. Potential novel predictive biomarkers for early diagnosis of CRS-1 incidence and vulnerable-phase outcomes in ADHF patients include the recently discovered pPENK and the noninvasive test of uNT-proBNP/uCr ratio (pg/nmol) on admission.

Source: tandfonline.com/doi/full/10.1080/0886022X.2022.2114367