N-Terminal Pro-Brain Natriuretic Peptide and Risk of Cardiovascular Events in a Japanese Community

Abstract

Objective-Few studies have examined the association between natriuretic peptides and the incidence of cardiovascular disease (CVD) in Asian populations. Methods and Results-A total of 3104 community-dwelling Japanese individuals aged Ն40 years without history of CVD were followed up for 5 years. A total of 127 CVD events were identified. The age-and sex-adjusted incidence of CVD increased with increasing N-terminal pro-brain natriuretic peptide (NT-proBNP) levels (Ͻ55, 55-124, 125-399, and Ն400 pg/mL) at baseline and was significantly higher even in subjects with a modest increase. The multivariate-adjusted hazard ratios for the development of total CVD and its subtypes, coronary heart disease and stroke, were significantly increased by a 1 SD increment of the log NT-proBNP concentrations and were nearly equal among CVD subtypes. Similar findings were observed for stroke subtypes of ischemic stroke and intracerebral hemorrhage but not subarachnoid hemorrhage. The effects of the 1 SD increment in log NT-proBNP values were comparable in subjects with and without other cardiovascular risk factors, except for sex.The area under the receiver operating characteristic curve was significantly (Pϭ0.006) increased by adding NT-proBNP values to the model including other potential risk factors. Conclusion-Elevated NT-proBNP levels were shown to be a significant risk factor for the development of CVD and its subtypes in a general Japanese population, independently of other cardiovascular risk factors.

Correlations of arterial stiffness/central hemodynamics with serum cardiac troponin T and natriuretic peptide levels in a middle-aged male worksite cohort

“…Two cut-off points each were used to define elevations of the serum TnT level (!0.014 ng/mL and !0.010 ng/mL) [4,5,16,19] and elevation of the serum NTproBNP level (!125 pg/mL and !55 pg/mL) [17,20]. Diabetes mellitus was defined as a history of receiving medication for diabetes mellitus and/or glycated hemoglobin A1C !6.5%.…”

N-Terminal Pro-B-Type Natriuretic Peptide Is Not a Significant Predictor of Stroke Incidence After 5 Years ― The Ohasama Study ―

“…The Hisayama study followed up Japanese residents for 5 years, and found an elevated stroke risk in those with NT-proBNP ≥125.0 pg/mL. 9 The predictive value of NT-proBNP beyond 5 years, however, remains an unsettled issue in an Asian patients.…”

“…9,30 The C-statistic for cardiovascular disease prediction increased by 0.021 in the Hisayama study and by 0.016 in the German study after adding NT-proBNP to the base model. 9,30…”

“…For participants with unknown habitual exercise (n=119) or daily sleep hours (n=110), we set design variables coded 1 if the data were missing (data present=0), respectively. Given that NT-proBNP has been reported to predict stroke risk for 5 years, 9 we stratified follow-up according to a 5-year period. The short-term predictive value of NTproBNP was assessed using HR, after setting the maximum follow-up period as 5 years.…”

Association between N-terminal pro B-type natriuretic peptide and day-to-day blood pressure and heart rate variability in a general population

“…We first assessed associations between the characteristics of the participants and NT-proBNP at least 125 pg/ml, which indicates heart failure [11,20,21]. We then compared means and proportions using Student's t-test, and the chi-squared or Fisher's exact tests.…”