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Serial NT-proBNP measurements improve risk stratification of patients with pre-Heart Failure
![Serial NT-proBNP measurements improve risk stratification of patients with pre-Heart Failure Serial NT-proBNP measurements improve risk stratification of patients with pre-Heart Failure](https://medicaldialogues.in/h-upload/2023/01/12/750x450_197811-heart-failure-4.webp)
U.S.A: A new study found that serial N-terminal B-type natriuretic peptide (NT-proBNP) measurements helped in risk stratification of patients with pre-Heart Failure. A 6-year change in NT-proBNP has shown a dynamic change in risk for HF events and death among community-dwelling adults without prevalent clinical HF. The study results were published in the journal JAMA Cardiology.
NT-proBNP is a well-established biomarker in the diagnosis and prognosis of Heart failure. Incident heart failure events were associated with elevated levels of circulating NT-proBNP. As most of the past guidelines stated that patients with higher NT-proBNP levels were classified as pre-HF, researchers conducted a study to evaluate if NT-proBNP level alterations are associated with future cardiovascular risk among middle-aged individuals without prevalent HF and assess changes in modifiable risk factors like the blood pressure, lipids, and BMI, are associated with a change in NT-proBNP.
Participants enrolled in the Atherosclerosis Risk in Community (ARIC) study from 4 US communities were recruited for the study. Individuals who attended ARIC visit 2 and 4 with 6 years apart and who were having NT-proBNP measurements without any prevalent HF were included in the study. Assays of NT-proBNP were carried out between 2011 and 2013, and analysis was done between July 2021 and October 2022. NT-proBNP change between visits 2 and 4 was the primary exposure variable, modeled as change categories (<125 pg/mL or ≥125 pg/mL) and as percent change. Incident HF hospitalization and all-cause death were the primary outcome measures. Changes in cardiovascular risk factors with consequent changes in NT-proBNP levels were also assessed.
Key findings:
- There were a total of 9776 individuals with a mean [SD] age, of 57.1 [5.7] years at visit 2 and out of which 5523 [56.5%] were women.
- There was a high risk of incident HF and mortality risk in participants with NT-proBNP level of 125 pg/mL or higher at both visits when compared with participants with NT-having proBNP level less than 125 pg/mL at both visits.
- The risk of HF and death in participants with NT-proBNP levels of 125 pg/mL or higher at visit 2 and less than 125 pg/mL at visit 4 was similar to the group with NT-proBNP levels of less than 125 pg/mL at both visits.
- The percent change in NT-proBNP was positively associated with HF and death.
- Changes in the levels of systolic blood pressure, low-density lipoprotein cholesterol, triglyceride level, body mass index, and estimated glomerular filtration rate were significantly associated with changes in NT-proBNP.
Thus, change in NT-proBNP over 6 years was associated with the risk of incident HF and mortality among middle-aged adults without clinical HF.
Further reading: Jia X, Al Rifai M, Hoogeveen R, et al. Association of Long-term Change in N-Terminal Pro–B-Type Natriuretic Peptide With Incident Heart Failure and Death. JAMA Cardiol. Published online February 08, 2023. doi: 10.1001/jamacardio.2022.5309
BDS, MDS
Dr.Niharika Harsha B (BDS,MDS) completed her BDS from Govt Dental College, Hyderabad and MDS from Dr.NTR University of health sciences(Now Kaloji Rao University). She has 4 years of private dental practice and worked for 2 years as Consultant Oral Radiologist at a Dental Imaging Centre in Hyderabad. She worked as Research Assistant and scientific writer in the development of Oral Anti cancer screening device with her seniors. She has a deep intriguing wish in writing highly engaging, captivating and informative medical content for a wider audience. She can be contacted at editorial@medicaldialogues.in.
Dr Kamal Kant Kohli-MBBS, DTCD- a chest specialist with more than 30 years of practice and a flair for writing clinical articles, Dr Kamal Kant Kohli joined Medical Dialogues as a Chief Editor of Medical News. Besides writing articles, as an editor, he proofreads and verifies all the medical content published on Medical Dialogues including those coming from journals, studies,medical conferences,guidelines etc. Email: editorial@medicaldialogues.in. Contact no. 011-43720751