N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study
Abstract Background N-terminal pro B-type peptide (NT-proBNP) has been associated with risk of myocardial infarction (MI), but less is known about the relationship between NT-proBNP and very small non ST-elevation MI, also known as microsize MI. These events are now routinely detectable with modern...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12872-018-0806-4 |
| _version_ | 1819117843249102848 |
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| author | Madeline R. Sterling Raegan W. Durant Joanna Bryan Emily B. Levitan Todd M. Brown Yulia Khodneva Stephen P. Glasser Joshua S. Richman George Howard Mary Cushman Monika M. Safford |
| author_facet | Madeline R. Sterling Raegan W. Durant Joanna Bryan Emily B. Levitan Todd M. Brown Yulia Khodneva Stephen P. Glasser Joshua S. Richman George Howard Mary Cushman Monika M. Safford |
| author_sort | Madeline R. Sterling |
| collection | DOAJ |
| description | Abstract Background N-terminal pro B-type peptide (NT-proBNP) has been associated with risk of myocardial infarction (MI), but less is known about the relationship between NT-proBNP and very small non ST-elevation MI, also known as microsize MI. These events are now routinely detectable with modern troponin assays and are emerging as a large proportion of all MI. Here, we sought to compare the association of NT-proBNP with risk of incident typical MI and microsize MI in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Methods The REGARDS Study is a national cohort of 30,239 US community-dwelling black and white adults aged ≥ 45 years recruited from 2003 to 2007. Expert-adjudicated outcomes included incident typical MI (definite/probable MI with peak troponin ≥ 0.5 μg/L), incident microsize MI (definite/probable MI with peak troponin < 0.5 μg/L), and incident fatal CHD. Using a case-cohort design, we estimated the hazard ratio of the outcomes as a function of baseline NT-proBNP. Competing risk analyses tested whether the associations of NT-proBNP differed between the risk of incident microsize MI and incident typical MI as well as if the association of NT-proBNP differed between incident non-fatal microsize MI and incident non-fatal typical MI, while accounting for incident fatal coronary heart disease (CHD) as well as heart failure (HF). Results Over a median of 5 years of follow-up, there were 315 typical MI, 139 microsize MI, and 195 incident fatal CHD. NT-proBNP was independently and strongly associated with all CHD endpoints, with significantly greater risk observed for incident microsize MI, even after removing individuals with suspected HF prior to or coincident with their incident CHD event. Conclusion NT-proBNP is associated with all MIs, but is a more powerful risk factor for microsize than typical MI. |
| first_indexed | 2024-12-22T05:39:25Z |
| format | Article |
| id | doaj.art-3b827c8d3d284036ae169b9c43d30fc1 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-22T05:39:25Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-3b827c8d3d284036ae169b9c43d30fc12022-12-21T18:37:14ZengBMCBMC Cardiovascular Disorders1471-22612018-04-011811910.1186/s12872-018-0806-4N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke studyMadeline R. Sterling0Raegan W. Durant1Joanna Bryan2Emily B. Levitan3Todd M. Brown4Yulia Khodneva5Stephen P. Glasser6Joshua S. Richman7George Howard8Mary Cushman9Monika M. Safford10Division of General Internal Medicine, Department of Medicine, Weill Cornell Medical CollegeDivision of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham School of MedicineDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medical CollegeDepartment of Epidemiology, University of Alabama at Birmingham School of Public HealthDivision of Cardiovascular Disease, Department of Medicine, University of Alabama at Birmingham School of MedicineDivision of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham School of MedicineDepartment of Internal Medicine, University of Kentucky College of MedicineDepartment of Surgery, University of Alabama at Birmingham School of MedicineDepartment of Biostatistics, University of Alabama at Birmingham School of Public HealthDepartments of Medicine and Pathology, Larner College of Medicine at the University of VermontDivision of General Internal Medicine, Department of Medicine, Weill Cornell Medical CollegeAbstract Background N-terminal pro B-type peptide (NT-proBNP) has been associated with risk of myocardial infarction (MI), but less is known about the relationship between NT-proBNP and very small non ST-elevation MI, also known as microsize MI. These events are now routinely detectable with modern troponin assays and are emerging as a large proportion of all MI. Here, we sought to compare the association of NT-proBNP with risk of incident typical MI and microsize MI in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study. Methods The REGARDS Study is a national cohort of 30,239 US community-dwelling black and white adults aged ≥ 45 years recruited from 2003 to 2007. Expert-adjudicated outcomes included incident typical MI (definite/probable MI with peak troponin ≥ 0.5 μg/L), incident microsize MI (definite/probable MI with peak troponin < 0.5 μg/L), and incident fatal CHD. Using a case-cohort design, we estimated the hazard ratio of the outcomes as a function of baseline NT-proBNP. Competing risk analyses tested whether the associations of NT-proBNP differed between the risk of incident microsize MI and incident typical MI as well as if the association of NT-proBNP differed between incident non-fatal microsize MI and incident non-fatal typical MI, while accounting for incident fatal coronary heart disease (CHD) as well as heart failure (HF). Results Over a median of 5 years of follow-up, there were 315 typical MI, 139 microsize MI, and 195 incident fatal CHD. NT-proBNP was independently and strongly associated with all CHD endpoints, with significantly greater risk observed for incident microsize MI, even after removing individuals with suspected HF prior to or coincident with their incident CHD event. Conclusion NT-proBNP is associated with all MIs, but is a more powerful risk factor for microsize than typical MI.http://link.springer.com/article/10.1186/s12872-018-0806-4Coronary heart diseaseB-type natriuretic peptideMircosize myocardial infarctionRacial disparitiesCohort study |
| spellingShingle | Madeline R. Sterling Raegan W. Durant Joanna Bryan Emily B. Levitan Todd M. Brown Yulia Khodneva Stephen P. Glasser Joshua S. Richman George Howard Mary Cushman Monika M. Safford N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study BMC Cardiovascular Disorders Coronary heart disease B-type natriuretic peptide Mircosize myocardial infarction Racial disparities Cohort study |
| title | N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study |
| title_full | N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study |
| title_fullStr | N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study |
| title_full_unstemmed | N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study |
| title_short | N-terminal pro-B-type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study |
| title_sort | n terminal pro b type natriuretic peptide and microsize myocardial infarction risk in the reasons for geographic and racial differences in stroke study |
| topic | Coronary heart disease B-type natriuretic peptide Mircosize myocardial infarction Racial disparities Cohort study |
| url | http://link.springer.com/article/10.1186/s12872-018-0806-4 |
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