Abstract 13570: Plasma B-type Natriuretic Peptide is a Potent Predictive Biomarker for the Onset of Cardiovascular Events in a High Risk Population
Background: B-type natriuretic peptide (BNP) has been suggested to be a useful predictor of the development of heart failure in the general population. However, it remains unknown whether this biomarker is valid for the prediction of general cardiovascular (CV) events in a CV high risk population selected from the general population.
Methods: Individuals at high risk for CV events were selected from the general population aged above 65 years on the basis of having one or more factors as follows; diabetes, atrial fibrillation, urinary albumin corrected by urinary creatinine above 30 mg/g. The number of subjects was 2,355 (mean age = 72 +/− 5 years). Cases admitted for CV events (heart failure, stroke, myocardial infarction, sudden death) in the cohort were surveyed using regional registration data. The cohort was divided into quartiles according to plasma BNP. The CV event free rate within each BNP quartile was estimated using the Kaplan-Meier method, followed by the log-rank test. A multivariate Cox regression analysis was performed to examine the relative risk of onset of CV events among the quartiles. The ability to predict CV events of plasma BNP levels and Framingham risk score (FRS) for general CV events were compared by the area under the curve (AUC) generated through receiver operating characteristic (ROC) analysis.
Results: The mean follow-up duration was 2.8 years. The event free rate among the BNP quartiles was clearly divergent (log-rank p < 0.001). After adjustment for established CV risk factors (age, sex, body mass index, hypertension, hypercholesterolemia, smoking, diabetes, and atrial fibrillation), the hazard ratio (HR) for CV events increased significantly according to the plasma BNP quartiles (p for trend < 0.001), and the HR for the fourth BNP quartile was significantly elevated compared with that for the first quartile (HR = 3.1, 95% CI; 1.6 – 6.0). The AUC for BNP was significantly greater than that for the FRS (0.705 vs. 0.606; p = 0.014)
Conclusion: An increased plasma BNP level is a potent predictor of the onset of general CV events in a high risk population.
- © 2010 by American Heart Association, Inc.