NT-proBNP is superior to BNP for predicting first cardiovascular events in the general population: The Heinz Nixdorf Recall Study

作者：Kara Kaffer^*; Lehmann Nils; Neumann Till; Kaelsch Hagen; Moehlenkamp Stefan; Dykun Iryna; Broecker Preuss Martina; Pundt Noreen; Moebus Susanne; Joeckel Karl Heinz; Erbel Raimund; Mahabadi Amir A

来源：International Journal of Cardiology, 2015, 183: 155-161.

DOI：10.1016/j.ijcard.2015.01.082

• Natriuretic peptides
• BN
• PNT-proBNP
• Risk prediction
• General population
• Epidemiology
• Heinz Nixdorf Recall Study

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.

• 出版日期2015-3-15
• 单位河北医科大学