NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort Study
Background NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) is strongly associated with mortality in patients with heart failure. Prior studies, primarily in middle‐aged and older populations, have suggested that NT‐proBNP has prognostic value in ambulatory adults. Methods and Results We conduc...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2023-06-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.122.029110 |
| _version_ | 1797810162770116608 |
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| author | Justin B. Echouffo‐Tcheugui Sui Zhang Natalie Daya John W. McEvoy Olive Tang Stephen P. Juraschek Chiadi E. Ndumele Josef Coresh Robert H. Christenson Elizabeth Selvin |
| author_facet | Justin B. Echouffo‐Tcheugui Sui Zhang Natalie Daya John W. McEvoy Olive Tang Stephen P. Juraschek Chiadi E. Ndumele Josef Coresh Robert H. Christenson Elizabeth Selvin |
| author_sort | Justin B. Echouffo‐Tcheugui |
| collection | DOAJ |
| description | Background NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) is strongly associated with mortality in patients with heart failure. Prior studies, primarily in middle‐aged and older populations, have suggested that NT‐proBNP has prognostic value in ambulatory adults. Methods and Results We conducted a prospective cohort analysis of adults, aged ≥20 years, in the nationally representative 1999 to 2004 National Health and Nutrition Examination Survey, to characterize the association of NT‐proBNP with mortality in the general US adult population overall and by age, race and ethnicity, and body mass index. We used Cox regression to characterize associations of NT‐proBNP with all‐cause and cardiovascular disease (CVD) mortality through 2019, adjusting for demographics and cardiovascular risk factors. We included 10 645 individuals (mean age, 45.7 years; 50.8% women; 72.8% White adults; 8.5% with a self‐reported history of CVD). There were 3155 deaths (1009 CVD‐related) over a median 17.3 years of follow‐up. Among individuals without prior CVD, elevated NT‐proBNP (≥75th percentile [81.5 pg/mL] versus <25th percentile [20.5 pg/mL]) was associated with a significantly higher risk of all‐cause (hazard ratio [HR], 1.67 [95% CI, 1.39–2.00]) and CVD mortality (HR, 2.87 [95% CI, 1.61–5.11]). Associations of NT‐proBNP with all‐cause and CVD mortality were generally similar across subgroups defined by age, sex, race and ethnicity, or body mass index (all P interaction >0.05). Conclusions In a representative sample of the US adult population, NT‐proBNP was an important independent risk factor for all‐cause and CVD mortality. NT‐proBNP may be useful for monitoring risk in the general adult population. |
| first_indexed | 2024-03-13T07:04:02Z |
| format | Article |
| id | doaj.art-157fcca856aa4dceb95441ac7f8d9500 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-13T07:04:02Z |
| publishDate | 2023-06-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-157fcca856aa4dceb95441ac7f8d95002023-06-06T12:15:47ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802023-06-01121110.1161/JAHA.122.029110NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort StudyJustin B. Echouffo‐Tcheugui0Sui Zhang1Natalie Daya2John W. McEvoy3Olive Tang4Stephen P. Juraschek5Chiadi E. Ndumele6Josef Coresh7Robert H. Christenson8Elizabeth Selvin9Division of Endocrinology, Diabetes and Metabolism, Department of Medicine Johns Hopkins University Baltimore MDDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health Baltimore MDDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health Baltimore MDDivision of Cardiology and National Institute for Prevention and Cardiovascular Health National University of Ireland Galway IrelandJohns Hopkins School of Medicine Johns Hopkins University Baltimore MDDivision of General Medicine, Beth Israel Deaconess Medical Center Harvard Medical School Boston MADivision of Cardiology, Department of Medicine Johns Hopkins University Baltimore MDDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health Baltimore MDDepartment of Pathology University of Maryland School of Medicine Baltimore MDDepartment of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research Johns Hopkins Bloomberg School of Public Health Baltimore MDBackground NT‐proBNP (N‐terminal pro‐B‐type natriuretic peptide) is strongly associated with mortality in patients with heart failure. Prior studies, primarily in middle‐aged and older populations, have suggested that NT‐proBNP has prognostic value in ambulatory adults. Methods and Results We conducted a prospective cohort analysis of adults, aged ≥20 years, in the nationally representative 1999 to 2004 National Health and Nutrition Examination Survey, to characterize the association of NT‐proBNP with mortality in the general US adult population overall and by age, race and ethnicity, and body mass index. We used Cox regression to characterize associations of NT‐proBNP with all‐cause and cardiovascular disease (CVD) mortality through 2019, adjusting for demographics and cardiovascular risk factors. We included 10 645 individuals (mean age, 45.7 years; 50.8% women; 72.8% White adults; 8.5% with a self‐reported history of CVD). There were 3155 deaths (1009 CVD‐related) over a median 17.3 years of follow‐up. Among individuals without prior CVD, elevated NT‐proBNP (≥75th percentile [81.5 pg/mL] versus <25th percentile [20.5 pg/mL]) was associated with a significantly higher risk of all‐cause (hazard ratio [HR], 1.67 [95% CI, 1.39–2.00]) and CVD mortality (HR, 2.87 [95% CI, 1.61–5.11]). Associations of NT‐proBNP with all‐cause and CVD mortality were generally similar across subgroups defined by age, sex, race and ethnicity, or body mass index (all P interaction >0.05). Conclusions In a representative sample of the US adult population, NT‐proBNP was an important independent risk factor for all‐cause and CVD mortality. NT‐proBNP may be useful for monitoring risk in the general adult population.https://www.ahajournals.org/doi/10.1161/JAHA.122.029110biomarkersbraincardiovascular diseaseepidemiologymortalitynatriuretic peptide |
| spellingShingle | Justin B. Echouffo‐Tcheugui Sui Zhang Natalie Daya John W. McEvoy Olive Tang Stephen P. Juraschek Chiadi E. Ndumele Josef Coresh Robert H. Christenson Elizabeth Selvin NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort Study Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease biomarkers brain cardiovascular disease epidemiology mortality natriuretic peptide |
| title | NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort Study |
| title_full | NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort Study |
| title_fullStr | NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort Study |
| title_full_unstemmed | NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort Study |
| title_short | NT‐proBNP and All‐Cause and Cardiovascular Mortality in US Adults: A Prospective Cohort Study |
| title_sort | nt probnp and all cause and cardiovascular mortality in us adults a prospective cohort study |
| topic | biomarkers brain cardiovascular disease epidemiology mortality natriuretic peptide |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.122.029110 |
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