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N-terminal Pro-B-Type Natriuretic Peptide, Left Ventricular Mass, and Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis.
MedLine Citation:
PMID:  23032197     Owner:  NLM     Status:  Publisher    
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 the 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 (MRI) defined LV mass index with incident HF in an asymptomatic multi-ethnic population. METHODS AND RESULTS: -A total of 5597 multiethnic 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 MRI. 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, smoking, estimated glomerular filtration rate, medications (anti-hypertensive and statin), LV mass index and interim myocardial infarction [HR 1.95 per 1 unit 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 (NRI; 6-year risk probability categorized by <3%, 3-10%, >10%) =0.175, p=0.019; category-less NRI=0.561, p<0.001]. CONCLUSIONS: -Plasma NT-proBNP provides incremental prognostic information beyond traditional risk factors and the MRI determined LV mass index for incident symptomatic HF in an asymptomatic multiethnic population. Clinical Trial Registration-URL: Unique identifier: NCT00005487.
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:  JOURNAL ARTICLE     Date:  2012-10-2
Journal Detail:
Title:  Circulation. Heart failure     Volume:  -     ISSN:  1941-3297     ISO Abbreviation:  Circ Heart Fail     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-3     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479941     Medline TA:  Circ Heart Fail     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
1 Johns Hopkins University, Baltimore, MD & Yonsei University College of Medicine, Seoul, South Korea;
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