Abstract
We have previously reported that signal peptide fragments of C-type natriuretic peptide (CNP) are present in the human circulation. Here, we provide the first preliminary assessment of the potential utility of CNP signal peptide (CNPsp) measurement in acute cardiovascular disease. Utilizing our specific and sensitive immunoassay, we assessed the potential of CNPsp measurement to assist in the identification of acute coronary syndromes in 494 patients presenting consecutively with chest pain. The diagnostic and prognostic potential of CNPsp were assessed in conjunction with a contemporary clinical troponin I assay, an investigational highly sensitive troponin T assay and NT-proBNP measurement. Utility was assessed via receiver operator curve characteristic analysis. CNPsp did not identify patients with myocardial infarction (MI) or those with unstable angina, nor did it assist the diagnostic ability of clinical or investigational troponin measurement. CNPsp levels were significantly elevated in patients presenting with atrial fibrillation (P < 0.05) and were significantly lower in those with a history of previous MI (P < 0.05). CNPsp could identify those at risk of mortality within 1 year (P < 0.05) and also could identify those at risk of death or re-infarction within 1 year (P < 0.01). This is the first exploratory report describing the potential of CNPsp measurement in acute cardiovascular disease. While CNPsp does not have utility in acute diagnosis, it may have potential in assisting risk prognosis with respect to mortality and re-infarction.
Highlights
We have recently reported that signal peptide (SP) fragments derived from each of A-type natriuretic peptide (ANP), B-type natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) are present in the human circulation [1,2,3]
Whereas circulating concentrations of ANP and BNP are predominately influenced by cardiac secretion [1, 2], CNP gene-derived peptides appear to be secreted from multiple organs and are Abbreviations: AF, atrial fibrillation; CNP, C-type natriuretic peptide; CNP signal peptide (CNPsp), C-type natriuretic peptide signal peptide; STEMI, ST-elevation myocardial infarction; UA, unstable angina
Our previous report [3] suggested that plasma concentrations of CNP signal peptide (CNPsp) may be more reliant on cardiac and renal production and that plasma levels of CNPsp were raised in patients suffering STEMI
Summary
We have recently reported that signal peptide (SP) fragments derived from each of A-type natriuretic peptide (ANP), B-type natriuretic peptide (BNP), and C-type natriuretic peptide (CNP) are present in the human circulation [1,2,3]. Our previous report [3] suggested that plasma concentrations of CNP signal peptide (CNPsp) may be more reliant on cardiac and renal production and that plasma levels of CNPsp were raised in patients suffering STEMI. Given this background, we report preliminary, exploratory findings on CNPsp measurement in patients with chest pain suggestive of an acute coronary syndrome (ACS), presenting to single center, hospital emergency department. The aim of this work was to determine if CNPsp measurement might have potential utility in the diagnosis and/or prognosis of patients with chest pain
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
