Abstract 3487: NT-proBNP Independently Predicts Cardiovascular Morbidity And Mortality In The General Population
Background: The prognostic value of N-terminal pro-B-type Natriuretic Peptide (NT-proBNP) has not been well established in the general population.
Methods: Of the population based Prevention of Renal and Vascular Endstage Disease (PREVEND) study, 8383 subjects were prospectively studied with a median follow-up of 7.5 years. Using probability weighted Cox Proportional-Hazards Regression, we investigated the prognostic properties of NT-proBNP to the risk of a cardiovascular (CV) event (myocardial infarction (MI), cerebrovascular disease, PTCA and CABG) and death.
Results: The population consisted of 4181 (49.9%) males and 4202 (50.1%) females. Mean age was 49.3 ± 12.7 years (28 –75). Prevalence of smoking, hypertension and diabetes mellitus type 2 were 37.8%, 32.0% and 3.8% respectively. NT-proBNP levels (median 37.7, 25–75% 16.8 –73.8 pg/ml) were associated with age, gender, smoking, hypertension, hypercholesterolemia, renal function, pre-existing ECG-diagnosed LVH, history of MI and stroke. Five year incidences of CV morbidity/mortality were 3.50% (95% CI 3.10 –3.97): cerebral event and cardiac event rates 0.77 % (95% CI 0.60 –1.00) and 2.73% (95% CI 2.38 –3.16) respectively. Age and sex adjusted fitted Hazard Ratios for CV, cerebral and cardiac morbidity/mortality were strongly related to NT-proBNP (Figure⇓; all p < 0.001). A doubling of NT-proBNP was associated with a 1.24 (95% CI 1.23–1.25), 1.22 (95% CI 1.21–1.23), 1.25 (95% CI 1.23–1.28) increased risk of CV, cardiac and cerebral morbidity/mortality, respectively.
Conclusion: The present study shows that NT-proBNP is a strong predictor of cardiovascular morbidity/mortality in the general population.