Document Detail


N-terminal pro-B-type natriuretic peptide, left ventricular mass, and incident heart failure: Multi-Ethnic Study of Atherosclerosis.
MedLine Citation:
PMID:  23032197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00005487.
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
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2012-10-02
Journal Detail:
Title:  Circulation. Heart failure     Volume:  5     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-21     Completed Date:  2013-04-01     Revised Date:  2014-08-10    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  United States    
Other Details:
Languages:  eng     Pagination:  727-34     Citation Subset:  IM    
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00005487
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MeSH Terms
Descriptor/Qualifier:
African Americans / ethnology
Aged
Asian Americans / ethnology
Biological Markers / blood
European Continental Ancestry Group / ethnology
Female
Follow-Up Studies
Heart Failure / diagnosis*,  epidemiology*,  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
Grant Support
ID/Acronym/Agency:
N01-HC-95162/HC/NHLBI NIH HHS; N01-HC-95168/HC/NHLBI NIH HHS; N01-HC-95169/HC/NHLBI NIH HHS; R01-HL66075-01/HL/NHLBI NIH HHS; ZIA CL090019-04/CL/CLC NIH HHS; ZIA EB000072-04/EB/NIBIB NIH HHS
Chemical
Reg. No./Substance:
0/Biological Markers; 0/Peptide Fragments; 0/pro-brain natriuretic peptide (1-76); 114471-18-0/Natriuretic Peptide, Brain
Comments/Corrections

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