Kaffer Kara1, Nils Lehmann2, Till Neumann3, Hagen Kälsch3, Stefan Möhlenkamp4, Iryna Dykun3, Martina Broecker-Preuss5, Noreen Pundt2, Susanne Moebus2, Karl-Heinz Jöckel2, Raimund Erbel3, Amir A Mahabadi3. 1. The Cardiovascular Center, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany; The West-German Heart Center, Department of Cardiology, University of Duisburg-Essen, Essen, Germany. Electronic address: k.kara@klinikum-bochum.de. 2. The Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany. 3. The West-German Heart Center, Department of Cardiology, University of Duisburg-Essen, Essen, Germany. 4. Krankenhaus Bethanien, Department of Cardiology, Moers, Germany. 5. Institute of Clinical Chemistry and Laboratory Medicine, University of Duisburg-Essen, Essen, Germany.
Abstract
BACKGROUND: B-type natriuretic peptide (BNP) as well as N-terminal-proBNP (NT-proBNP) are associated with cardiac events in the general population. Yet, data from the general population comparing both peptides for their prognostic value is lacking. METHODS: Participants from the population-based Heinz-Nixdorf-Recall-study without cardiovascular diseases were included. Associations of BNP and NT-proBNP with incident cardiovascular events (incident myocardial infarction, stroke, or cardiovascular death) were assessed using Cox regression; prognostic value was addressed using Harrell's c statistic. RESULTS: From overall 3589 subjects (mean age: 59.3 ± 7.7 yrs, 52.5% female), 235 subjects developed a cardiovascular event during 8.9 ± 2.2 yrs of follow-up. In regression analysis both natriuretic peptides were associated with incident cardiovascular events, independent of traditional risk factors (hazard ratio (HR) per unit increase on log-scale (95% CI): NT-proBNP: 1.60 (1.39; 1.84); BNP: 1.37 (1.19; 1.58), p<0.0001 respectively). Specifically looking at subjects <60 yrs only NT-proBNP, was linked with events (HR (95% CI): 1.59 (1.19; 2.13) for NT-proBNP, p=0.0019; HR: 1.25 (0.94; 1.65) for BNP, p=0.12, after adjustment for age and gender). Similar results were observed for females (HR (95% CI) 1.65 (1.28; 2.12), p=0.0001 for NT-proBNP, and 1.24 (0.96; 1.61), p=0.10 for BNP after adjustment for age). Adding NT-proBNP/BNP to traditional risk factors increased the prognostic value, with effects being stronger for NT-proBNP (Harrell's c, 0.724 to 0.741, p=0.034) as compared to BNP (0.724 to 0.732, p=0.20). CONCLUSION: Both, NT-proBNP and BNP are associated with future cardiovascular events in the general population. However, when both are available, NT-proBNP seems to be superior due to its higher prognostic value, especially in younger subjects and females.
BACKGROUND:B-type natriuretic peptide (BNP) as well as N-terminal-proBNP (NT-proBNP) are associated with cardiac events in the general population. Yet, data from the general population comparing both peptides for their prognostic value is lacking. METHODS:Participants from the population-based Heinz-Nixdorf-Recall-study without cardiovascular diseases were included. Associations of BNP and NT-proBNP with incident cardiovascular events (incident myocardial infarction, stroke, or cardiovascular death) were assessed using Cox regression; prognostic value was addressed using Harrell's c statistic. RESULTS: From overall 3589 subjects (mean age: 59.3 ± 7.7 yrs, 52.5% female), 235 subjects developed a cardiovascular event during 8.9 ± 2.2 yrs of follow-up. In regression analysis both natriuretic peptides were associated with incident cardiovascular events, independent of traditional risk factors (hazard ratio (HR) per unit increase on log-scale (95% CI): NT-proBNP: 1.60 (1.39; 1.84); BNP: 1.37 (1.19; 1.58), p<0.0001 respectively). Specifically looking at subjects <60 yrs only NT-proBNP, was linked with events (HR (95% CI): 1.59 (1.19; 2.13) for NT-proBNP, p=0.0019; HR: 1.25 (0.94; 1.65) for BNP, p=0.12, after adjustment for age and gender). Similar results were observed for females (HR (95% CI) 1.65 (1.28; 2.12), p=0.0001 for NT-proBNP, and 1.24 (0.96; 1.61), p=0.10 for BNP after adjustment for age). Adding NT-proBNP/BNP to traditional risk factors increased the prognostic value, with effects being stronger for NT-proBNP (Harrell's c, 0.724 to 0.741, p=0.034) as compared to BNP (0.724 to 0.732, p=0.20). CONCLUSION: Both, NT-proBNP and BNP are associated with future cardiovascular events in the general population. However, when both are available, NT-proBNP seems to be superior due to its higher prognostic value, especially in younger subjects and females.
Authors: Alexander Dietl; Klaus Stark; Martina E Zimmermann; Christa Meisinger; Heribert Schunkert; Christoph Birner; Lars S Maier; Annette Peters; Iris M Heid; Andreas Luchner Journal: PLoS One Date: 2016-10-06 Impact factor: 3.240
Authors: Peter Willeit; Stephen Kaptoge; Paul Welsh; Adam Butterworth; Rajiv Chowdhury; Sarah Spackman; Lisa Pennells; Pei Gao; Stephen Burgess; Daniel Freitag; Michael Sweeting; Angela Wood; Nancy Cook; Suzanne Judd; Stella Trompet; Vijay Nambi; Michael Olsen; Brendan Everett; Frank Kee; Johan Ärnlöv; Veikko Salomaa; Daniel Levy; Jussi Kauhanen; Jari Laukkanen; Maryam Kavousi; Toshiharu Ninomiya; Juan-Pablo Casas; Lori Daniels; Lars Lind; Caroline Kistorp; Jens Rosenberg; Thomas Mueller; Speranza Rubattu; Demosthenes Panagiotakos; Oscar Franco; James de Lemos; Andreas Luchner; Jorge Kizer; Stefan Kiechl; Jukka Salonen; S Goya Wannamethee; Rudolf de Boer; Børge Nordestgaard; Jonas Andersson; Torben Jørgensen; Olle Melander; Christie Ballantyne; Christopher DeFilippi; Paul Ridker; Mary Cushman; Wayne Rosamond; Simon Thompson; Vilmundur Gudnason; Naveed Sattar; John Danesh; Emanuele Di Angelantonio Journal: Lancet Diabetes Endocrinol Date: 2016-09-03 Impact factor: 44.867