An Assessment of Brain Natriuretic Peptide (BNP), Urokinase Plasminogen Activator (uPA) and Wingless Type 5A (WINT5A) in Iraqi Patients with Heart Failure

Biochemical markers like brain natriuretic peptide (BNP) are being identified in patients with heart failure (HF) to indicate the severity of the condition. Little is known about Urokinase plasminogen activator (uPa) and wingless type 5A(Wint5a) markers. The study investigates the role of serum BNP concentration in diagnosing HF and its impact on survival and prognosis in patients with impaired renal function. 150 individuals participated in this study (100 as patients and 50 as control), patients were classified according to renal dysfunction into two groups 50 patients with HF and renal dysfunction (RD), 50 patients with HF without RD. According to the area under curve 81 %, indicated BNP is a good indicator to determine HF with RD p-value <0.05, cutoff value 0.35 at which HF is diagnosed, sensitivity 0.78 and specificity 0.73, CI 95% (0.74–0.88). While uPa and Wint5a revealed fair indicator. BNP and Wint5a showed significant correlations with urea, creatinine, and uric acid but not with uPa. BNP levels of patients with RD showed a positive significant correlation with creatinine levels, and the critical point of BNP level for diagnosis of heart failure was 0.855 ng/mL while in Wint5a was 0.877 ng/ml and fair result with uPa. As the survival rate in patients with BNP level above the critical point was significantly low, this level was a useful indicator for predicting their prognosis. Care should be taken in interpreting BNP and Wint5a level because patients with RD may show a high concentration of BNP with and without heart failure.