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N-terminal pro-B-type natriuretic peptide, left ventricular mass, and incident heart failure: Multi-Ethnic Study of Atherosclerosis.

Authors
 Eui-Young Choi  ;  Hossein Bahrami  ;  Colin O. Wu  ;  Philip Greenland  ;  Mary Cushman  ;  Lori B. Daniels  ;  Andre L.C. Almeida  ;  Kihei Yoneyama  ;  Anders Opdahl  ;  Aditya Jain  ;  Michael H. Criqui  ;  David Siscovick  ;  Christine Darwin  ;  Alan Maisel  ;  David A. Bluemke  ;  Joao A.C. Lima 
Citation
 CIRCULATION-HEART FAILURE, Vol.5(6) : 727-734, 2012 
Journal Title
 CIRCULATION-HEART FAILURE 
ISSN
 1941-3289 
Issue Date
2012
MeSH
African Americans/ethnology ; Aged ; Asian Americans/ethnology ; Biomarkers/blood ; European Continental Ancestry Group/ethnology ; Female ; Follow-Up Studies ; Heart Failure/diagnosis* ; Heart Failure/epidemiology* ; Heart Failure/ethnology ; Hispanic Americans/ethnology ; Humans ; Hypertrophy, Left Ventricular/pathology* ; Incidence ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood* ; Peptide Fragments/blood* ; Predictive Value of Tests ; Prospective Studies ; Risk Factors
Keywords
African Americans/ethnology ; Aged ; Asian Americans/ethnology ; Biomarkers/blood ; European Continental Ancestry Group/ethnology ; Female ; Follow-Up Studies ; Heart Failure/diagnosis* ; Heart Failure/epidemiology* ; Heart Failure/ethnology ; Hispanic Americans/ethnology ; Humans ; Hypertrophy, Left Ventricular/pathology* ; Incidence ; Longitudinal Studies ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Natriuretic Peptide, Brain/blood* ; Peptide Fragments/blood* ; Predictive Value of Tests ; Prospective Studies ; Risk Factors
Abstract
BACKGROUND: Elevated N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with clinically overt heart failure (HF). However, whether it provides additive prognostic information for incident HF beyond traditional risk factors and left ventricular (LV) mass index among multi-ethnic asymptomatic individuals has not yet been determined. We studied the associations of plasma NT-proBNP and magnetic resonance imaging defined LV mass index with incident HF in an asymptomatic multi-ethnic population. METHODS AND RESULTS: A total of 5597 multi-ethnic participants without clinically apparent cardiovascular disease underwent baseline measurement of NT-proBNP and were followed for 5.5±1.1 years. Among them, 4163 also underwent baseline cardiac magnetic resonance imaging. During follow-up, 111 participants experienced incident HF. Higher NT-proBNP was significantly associated with incident HF, independent of baseline age, sex, ethnicity, systolic blood pressure, diabetes mellitus, smoking, estimated glomerular filtration rate, medications (anti-hypertensive and statin), LV mass index, and interim myocardial infarction (hazard ratio: 1.95 per 1U log NT-proBNP increment, 95% CI 1.54-2.46, P<0.001). This relationship held among different ethnic groups, non-Hispanic whites, African-Americans, and Hispanics. Most importantly, NT-proBNP provided additive prognostic value beyond both traditional risk factors and LV mass index for predicting incident HF (integrated discrimination index=0.046, P<0.001; net reclassification index; 6-year risk probability categorized by <3%, 3-10%, >10% =0.175, P=0.019; category-less net reclassification index=0.561, P<0.001). CONCLUSIONS: Plasma NT-proBNP provides incremental prognostic information beyond traditional risk factors and the magnetic resonance imaging-determined LV mass index for incident symptomatic HF in an asymptomatic multi-ethnic population.
Files in This Item:
T201203939.pdf Download
DOI
23032197
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Eui Young(최의영) ORCID logo https://orcid.org/0000-0003-3732-0190
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89969
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