BACKGROUND: Plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) have been found to predict risk of sudden cardiac death (SCD) in patients with known cardiac disease, and C-reactive protein levels have been found to predict risk among apparently healthy men. However, there are no data on SCD risk prediction for either of these markers in a population of women unselected on the basis of cardiovascular disease. METHODS AND RESULTS: In a prospective, nested, case-control analysis within the 121,700-participant Nurses' Health Study, 99 cases of definite or probable SCD were identified and matched to 294 controls. In multivariable models that adjusted for coronary heart disease risk factors, glomerular filtration rate, and other biomarkers, the trend across quartiles approached significance for NT-proBNP (rate ratio=2.37 for comparison of the highest and lowest quartile; P for trend=0.05) but not for high-sensitivity C-reactive protein (P for trend=0.60). When examined continuously, both NT-proBNP and high-sensitivity C-reactive protein were significantly associated with SCD risk in age- and fasting-adjusted models (P for linear trend=0.04 and 0.03). Adjustment for coronary heart disease risk factors and other biomarkers strengthened the relationship with NT-proBNP and SCD (relative risk for 1-SD increment=1.49; 95% confidence interval, 1.09 to 2.05; P=0.01) but eliminated the relationship with high-sensitivity C-reactive protein (P=0.34). Women with NT-proBNP levels above the prespecified cut point of 389 pg/mL were at a markedly increased risk of SCD in both models (rate ratio=5.68; 95% confidence interval, 1.78 to 18.2; P=0.003). CONCLUSIONS: In this population of women, baseline levels of NT-proBNP were associated with subsequent risk of SCD. If this association is confirmed in larger prospectively studied populations, these findings might provide another useful marker contributing to efforts to screen and prevent SCD among women.
BACKGROUND: Plasma concentrations of N-terminal pro-B-type natriuretic peptide (NT-proBNP) have been found to predict risk of sudden cardiac death (SCD) in patients with known cardiac disease, and C-reactive protein levels have been found to predict risk among apparently healthy men. However, there are no data on SCD risk prediction for either of these markers in a population of women unselected on the basis of cardiovascular disease. METHODS AND RESULTS: In a prospective, nested, case-control analysis within the 121,700-participant Nurses' Health Study, 99 cases of definite or probable SCD were identified and matched to 294 controls. In multivariable models that adjusted for coronary heart disease risk factors, glomerular filtration rate, and other biomarkers, the trend across quartiles approached significance for NT-proBNP (rate ratio=2.37 for comparison of the highest and lowest quartile; P for trend=0.05) but not for high-sensitivity C-reactive protein (P for trend=0.60). When examined continuously, both NT-proBNP and high-sensitivity C-reactive protein were significantly associated with SCD risk in age- and fasting-adjusted models (P for linear trend=0.04 and 0.03). Adjustment for coronary heart disease risk factors and other biomarkers strengthened the relationship with NT-proBNP and SCD (relative risk for 1-SD increment=1.49; 95% confidence interval, 1.09 to 2.05; P=0.01) but eliminated the relationship with high-sensitivity C-reactive protein (P=0.34). Women with NT-proBNP levels above the prespecified cut point of 389 pg/mL were at a markedly increased risk of SCD in both models (rate ratio=5.68; 95% confidence interval, 1.78 to 18.2; P=0.003). CONCLUSIONS: In this population of women, baseline levels of NT-proBNP were associated with subsequent risk of SCD. If this association is confirmed in larger prospectively studied populations, these findings might provide another useful marker contributing to efforts to screen and prevent SCD among women.
Authors: Rudolf Berger; Martin Huelsman; Karin Strecker; Anja Bojic; Petra Moser; Brigitte Stanek; Richard Pacher Journal: Circulation Date: 2002-05-21 Impact factor: 29.690
Authors: Christine M Albert; Claudia U Chae; Francine Grodstein; Lynda M Rose; Kathryn M Rexrode; Jeremy N Ruskin; Meir J Stampfer; JoAnn E Manson Journal: Circulation Date: 2003-04-14 Impact factor: 29.690
Authors: Jari M Tapanainen; Kai S Lindgren; Timo H Mäkikallio; Olli Vuolteenaho; Juhani Leppäluoto; Heikki V Huikuri Journal: J Am Coll Cardiol Date: 2004-03-03 Impact factor: 24.094
Authors: Thomas J Wang; Martin G Larson; Daniel Levy; Emelia J Benjamin; Eric P Leip; Torbjorn Omland; Philip A Wolf; Ramachandran S Vasan Journal: N Engl J Med Date: 2004-02-12 Impact factor: 91.245
Authors: Sumeet S Chugh; Jonathan Jui; Karen Gunson; Eric C Stecker; Benjamin T John; Barbara Thompson; Nasreen Ilias; Catherine Vickers; Vivek Dogra; Mohamud Daya; Jack Kron; Zhi-Jie Zheng; George Mensah; John McAnulty Journal: J Am Coll Cardiol Date: 2004-09-15 Impact factor: 24.094
Authors: Kristen K Patton; Nona Sotoodehnia; Christopher DeFilippi; David S Siscovick; John S Gottdiener; Richard A Kronmal Journal: Heart Rhythm Date: 2010-10-30 Impact factor: 6.343
Authors: Tariq Ahmad; Mona Fiuzat; Benjamin Neely; Megan L Neely; Michael J Pencina; William E Kraus; Faiez Zannad; David J Whellan; Mark P Donahue; Ileana L Piña; Kirkwood F Adams; Dalane W Kitzman; Christopher M O'Connor; G Michael Felker Journal: JACC Heart Fail Date: 2014-06 Impact factor: 12.035