The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations
Abstract A higher neprilysin activity has been suggested in women. In this retrospective analysis, we evaluated the association of sex and body mass index (BMI) with soluble neprilysin (sNEP) and recurrent admissions among 1021 consecutive HF outpatients. The primary and secondary endpoints were the...
| Main Authors: | , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-03-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-021-85490-1 |
| _version_ | 1818400518940131328 |
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| author | Julio Núñez Eduardo Núñez Elena Revuelta-López Gema Miñana Jaume Barallat Vicent Bodi Juan Sanchis Alberto Aimo Michele Emdin Josep Lupón Oliver Husser Antoni Bayes-Genis |
| author_facet | Julio Núñez Eduardo Núñez Elena Revuelta-López Gema Miñana Jaume Barallat Vicent Bodi Juan Sanchis Alberto Aimo Michele Emdin Josep Lupón Oliver Husser Antoni Bayes-Genis |
| author_sort | Julio Núñez |
| collection | DOAJ |
| description | Abstract A higher neprilysin activity has been suggested in women. In this retrospective analysis, we evaluated the association of sex and body mass index (BMI) with soluble neprilysin (sNEP) and recurrent admissions among 1021 consecutive HF outpatients. The primary and secondary endpoints were the number of HF hospitalizations and all-cause mortality, respectively. The association between sNEP with either endpoint was evaluated across sex and BMI categories (≥ 25 kg/m2 vs. < 25 kg/m2). Bivariate count regression (Poisson) was used, and risk estimates were expressed as incidence rates ratio (IRR). During a median follow-up of 6.65 years (percentile 25%-percentile 75%:2.83–10.25), 702 (68.76%) patients died, and 406 (40%) had at least 1 HF hospitalization. Median values of sNEP and BMI were 0.64 ng/mL (0.39–1.22), and 26.9 kg/m2 (24.3–30.4), respectively. Left ventricle ejection fraction was < 40% in 78.9% of patients, and 28% were women. In multivariable analysis, sNEP (main effect) was positively associated with HF hospitalizations (p = 0.001) but not with mortality (p = 0.241). The predictive value of sNEP for HF hospitalizations varied non-linearly across sex and BMI categories (p-value for interaction = 0.003), with significant and positive effect only on women with BMI ≥ 25 kg/m2 (p = 0.039). For instance, compared to men, women with sNEP of 1.22 ng/mL (percentile 75%) showed a significantly increased risk (IRRs: 1.26; 95% CI: 1.05–1.53). The interaction analysis for mortality did not support a differential prognostic effect for sNEP (p = 0.072). In conclusion, higher sNEP levels in overweight women better predicted an increased risk of HF hospitalization. |
| first_indexed | 2024-12-14T07:37:51Z |
| format | Article |
| id | doaj.art-3f865008d40347dd8a7c671ef2f12a45 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-14T07:37:51Z |
| publishDate | 2021-03-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-3f865008d40347dd8a7c671ef2f12a452022-12-21T23:11:07ZengNature PortfolioScientific Reports2045-23222021-03-011111910.1038/s41598-021-85490-1The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizationsJulio Núñez0Eduardo Núñez1Elena Revuelta-López2Gema Miñana3Jaume Barallat4Vicent Bodi5Juan Sanchis6Alberto Aimo7Michele Emdin8Josep Lupón9Oliver Husser10Antoni Bayes-Genis11Cardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de ValènciaCardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de ValènciaCIBER CardiovascularCardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de ValènciaBiochemistry Department, Hospital Universitari Germans Trias i PujolCardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de ValènciaCardiology Department, Hospital Clínico Universitario, INCLIVA, Departamento de Medicina, Universitat de ValènciaInstitute of Life Sciences, Scuola Superiore Sant’AnnaCardiology Division, University Hospital of PisaCIBER CardiovascularKlinik für Innere Medizin I, Kardiologie, St. Johannes-Hospital DortmundCIBER CardiovascularAbstract A higher neprilysin activity has been suggested in women. In this retrospective analysis, we evaluated the association of sex and body mass index (BMI) with soluble neprilysin (sNEP) and recurrent admissions among 1021 consecutive HF outpatients. The primary and secondary endpoints were the number of HF hospitalizations and all-cause mortality, respectively. The association between sNEP with either endpoint was evaluated across sex and BMI categories (≥ 25 kg/m2 vs. < 25 kg/m2). Bivariate count regression (Poisson) was used, and risk estimates were expressed as incidence rates ratio (IRR). During a median follow-up of 6.65 years (percentile 25%-percentile 75%:2.83–10.25), 702 (68.76%) patients died, and 406 (40%) had at least 1 HF hospitalization. Median values of sNEP and BMI were 0.64 ng/mL (0.39–1.22), and 26.9 kg/m2 (24.3–30.4), respectively. Left ventricle ejection fraction was < 40% in 78.9% of patients, and 28% were women. In multivariable analysis, sNEP (main effect) was positively associated with HF hospitalizations (p = 0.001) but not with mortality (p = 0.241). The predictive value of sNEP for HF hospitalizations varied non-linearly across sex and BMI categories (p-value for interaction = 0.003), with significant and positive effect only on women with BMI ≥ 25 kg/m2 (p = 0.039). For instance, compared to men, women with sNEP of 1.22 ng/mL (percentile 75%) showed a significantly increased risk (IRRs: 1.26; 95% CI: 1.05–1.53). The interaction analysis for mortality did not support a differential prognostic effect for sNEP (p = 0.072). In conclusion, higher sNEP levels in overweight women better predicted an increased risk of HF hospitalization.https://doi.org/10.1038/s41598-021-85490-1 |
| spellingShingle | Julio Núñez Eduardo Núñez Elena Revuelta-López Gema Miñana Jaume Barallat Vicent Bodi Juan Sanchis Alberto Aimo Michele Emdin Josep Lupón Oliver Husser Antoni Bayes-Genis The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations Scientific Reports |
| title | The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_full | The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_fullStr | The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_full_unstemmed | The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_short | The influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| title_sort | influence of sex and body mass index on the association between soluble neprilysin and risk of heart failure hospitalizations |
| url | https://doi.org/10.1038/s41598-021-85490-1 |
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