N-terminal Pro-B-Type Natriuretic Peptide, Left Ventricular Mass, and Incident Heart Failure Multi-Ethnic Study of Atherosclerosis

作者：Choi Eui Young; Bahrami Hossein; Wu Colin O; Greenland Philip; Cushman Mary; Daniels Lori B; Almeida Andre L C; Yoneyama Kihei; Opdahl Anders; Jain Aditya; Criqui Michael H; Siscovick David; Darwin Christine; Maisel Alan; Bluemke David A; Lima Joao A C^*

来源：Circulation-Heart Failure, 2012, 5(6): 727-734.

DOI：10.1161/CIRCHEARTFAILURE.112.968701

• N-terminal pro-B-type natriuretic peptide
• heart failure
• left ventricular mass

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. %26lt;br%26gt;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%26lt;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%26lt;0.001; net reclassification index; 6-year risk probability categorized by %26lt;3%, 3-10%, %26gt;10% =0.175, P=0.019; category-less net reclassification index=0.561, P%26lt;0.001). %26lt;br%26gt;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.

• 出版日期2012-11
• 单位西北大学