Skip to main content
  • American Heart Association
  • Science Volunteer
  • Warning Signs
  • Advanced Search
  • Donate

  • Home
  • About this Journal
    • Editorial Board
    • General Statistics
    • Circulation Doodle
      • Doodle Gallery
      • Circulation Cover Doodle
        • → Blip the Doodle
    • Information for Advertisers
    • Author Reprints
    • Commercial Reprints
    • Customer Service and Ordering Information
    • Subscribe to AHA Journals
  • All Issues
  • Subjects
    • All Subjects
    • Arrhythmia and Electrophysiology
    • Basic, Translational, and Clinical Research
    • Critical Care and Resuscitation
    • Epidemiology, Lifestyle, and Prevention
    • Genetics
    • Heart Failure and Cardiac Disease
    • Hypertension
    • Imaging and Diagnostic Testing
    • Intervention, Surgery, Transplantation
    • Quality and Outcomes
    • Stroke
    • Vascular Disease
  • Browse Features
    • AHA Guidelines and Statements
      • Recently Published Guidelines
    • Bridging Disciplines
    • → Articles Bridging Discplines
    • Go Red for Women Issue
    • Cardiovascular Case Series
    • Circulation at ESC
    • Circulation at AHA Scientific Sessions
    • Global Impact of the 2017 ACC/AHA Hypertension Guidelines
    • Circulation at ACC 2018
    • Circulation Supplements
    • ECG Challenge
    • Hospitals of History
      • Brigham and Women's Hospital
      • Hartford Hospital
      • Hospital Santa Maria del Popolo, Naples, Italy
      • Instituto do Coração-INCOR (São Paulo, Brasil)
      • Minneapolis City Hospital
      • Parkland Hospital: Dallas, Texas
      • Pennsylvania Hospital, Philadelphia
      • Pitié-Salpêtrière Hospital
      • Royal Infirmary of Edinburgh, Scotland
      • Tufts Medical Center
      • University of Michigan
      • Uppsala University Hospital
      • Vassar Brothers Medical Center (Poughkeepsie, NY)
      • Wroclaw Medical University
      • Women's College Hospital, Toronto, Canada
      • Henry Ford Hospital, Detroit, Michigan
      • Instituto Nacional de Cardiología Ignacio Chávez – INCICh México City, México
      • Kuang-Tien General Hospital (Taichug, Taiwan)
    • On My Mind
    • Podcast Archive
    • → Subscribe to Circulation on the Run
    • →Circulation FIT Podcast 2018
    • → #FITFAVs
  • Resources
    • Instructions for Authors
      • Accepted Manuscripts
      • Revised Manuscripts
    • → Article Types
    • → General Preparation Instructions
    • → Research Guidelines
    • → How to Submit a Manuscript
    • Journal Policies
    • Permissions and Rights Q&A
    • Submission Sites
    • Circulation CME
    • AHA Journals RSS Feeds
    • International Users
    • AHA Newsroom
  • AHA Journals
    • AHA Journals Home
    • Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB)
    • Circulation
    • → Circ: Arrhythmia and Electrophysiology
    • → Circ: Genomic and Precision Medicine
    • → Circ: Cardiovascular Imaging
    • → Circ: Cardiovascular Interventions
    • → Circ: Cardiovascular Quality & Outcomes
    • → Circ: Heart Failure
    • Circulation Research
    • Hypertension
    • Stroke
    • Journal of the American Heart Association
  • Facebook
  • Twitter

  • My alerts
  • Sign In
  • Join

  • Advanced search

Header Publisher Menu

  • American Heart Association
  • Science Volunteer
  • Warning Signs
  • Advanced Search
  • Donate

Circulation

  • My alerts
  • Sign In
  • Join

  • Facebook
  • Twitter
  • Home
  • About this Journal
    • Editorial Board
    • General Statistics
    • Circulation Doodle
    • Information for Advertisers
    • Author Reprints
    • Commercial Reprints
    • Customer Service and Ordering Information
    • Subscribe to AHA Journals
  • All Issues
  • Subjects
    • All Subjects
    • Arrhythmia and Electrophysiology
    • Basic, Translational, and Clinical Research
    • Critical Care and Resuscitation
    • Epidemiology, Lifestyle, and Prevention
    • Genetics
    • Heart Failure and Cardiac Disease
    • Hypertension
    • Imaging and Diagnostic Testing
    • Intervention, Surgery, Transplantation
    • Quality and Outcomes
    • Stroke
    • Vascular Disease
  • Browse Features
    • AHA Guidelines and Statements
    • Bridging Disciplines
    • → Articles Bridging Discplines
    • Go Red for Women Issue
    • Cardiovascular Case Series
    • Circulation at ESC
    • Circulation at AHA Scientific Sessions
    • Global Impact of the 2017 ACC/AHA Hypertension Guidelines
    • Circulation at ACC 2018
    • Circulation Supplements
    • ECG Challenge
    • Hospitals of History
    • On My Mind
    • Podcast Archive
    • → Subscribe to Circulation on the Run
    • →Circulation FIT Podcast 2018
    • → #FITFAVs
  • Resources
    • Instructions for Authors
    • → Article Types
    • → General Preparation Instructions
    • → Research Guidelines
    • → How to Submit a Manuscript
    • Journal Policies
    • Permissions and Rights Q&A
    • Submission Sites
    • Circulation CME
    • AHA Journals RSS Feeds
    • International Users
    • AHA Newsroom
  • AHA Journals
    • AHA Journals Home
    • Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB)
    • Circulation
    • → Circ: Arrhythmia and Electrophysiology
    • → Circ: Genomic and Precision Medicine
    • → Circ: Cardiovascular Imaging
    • → Circ: Cardiovascular Interventions
    • → Circ: Cardiovascular Quality & Outcomes
    • → Circ: Heart Failure
    • Circulation Research
    • Hypertension
    • Stroke
    • Journal of the American Heart Association
Abstracts and presentations are embargoed for release at date and time of presentation or time of AHA/ASA news event. Information may not be released before then. Failure to honor embargo policies will result in the abstract being withdrawn and barred from presentation.
Poster Abstract PresentationsSession Title: Heart Failure

Abstract P021: NT-proBNP Predicts Incident Heart Failure Among Individuals in All BMI Categories

Chiadi E Ndumele, Kunihiro Matsushita, Yingying Sang, Mariana Lazo, Sunil K Agarwal, Vijay Nambi, Anita Deswal, Roger S Blumenthal, Christie M Ballantyne, Josef Coresh, Elizabeth Selvin
Circulation. 2014;129:AP021
Chiadi E Ndumele
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Kunihiro Matsushita
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Yingying Sang
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Mariana Lazo
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sunil K Agarwal
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Vijay Nambi
Michael E DeBakey Veterans Affairs Hosp, Houston, TX
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Anita Deswal
Michael E DeBakey Veterans Affairs Hosp, Houston, TX
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Roger S Blumenthal
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Christie M Ballantyne
Baylor College of Medicine, Houston, TX
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Josef Coresh
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Elizabeth Selvin
Johns Hopkins Univ, Baltimore, MD
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Info & Metrics

Jump to

  • Article
  • Info & Metrics
  • eLetters
Loading

Abstract

Background: The N-Terminal of pro-Brain Natriuretic Peptide (NT-proBNP) is a potent predictor of incident HF in the general population. Persons with obesity, despite their predisposition to developing HF, are known to have low NT-proBNP levels. The utility of NT-proBNP for HF prediction among individuals with obesity is therefore unclear.

Hypothesis: We hypothesized that NT-proBNP levels may predict incident HF differently across body mass index (BMI) categories.

Methods: We followed 12,509 ARIC participants free of prior HF at baseline (Visit 2, 1990-1992) with BMI ≥18.5 kg/m2 and available NT-proBNP. BMI (kg/m2) was categorized as normal (18.5-24.9), overweight (25-29.9), obese (30-34.9) and severely obese (≥35). The primary outcome was incident HF (1,986 events during a mean follow-up of 15.8 years). The potential effect modification of obesity on the NT-proBNP-HF relationship was assessed on both relative and absolute scales using multivariable Cox regression models. We also evaluated whether NT-proBNP improves HF prediction beyond traditional risk factors within the ARIC HF Risk Score similarly across BMI categories.

Results: As expected, higher BMI was associated with lower NT-proBNP (r=-0.09, p<0.0001). Within each BMI category, higher NT-proBNP levels were significantly and similarly associated with increased relative risk for HF (Figure 1A). However, given the higher incidence of HF associated with obesity, the absolute risk difference associated with higher NT-proBNP levels was greatest among individuals with severe obesity (Figure 1B). In all BMI categories, NT-proBNP significantly improved the C-statistic beyond the ARIC HF Risk Score (increases of 0.026 [0.009-0.043] and 0.033 [0.015-0.052] for normal weight and severely obese, respectively).

Conclusions: Despite the inverse relationship between NT-proBNP and obesity, NT-proBNP provides significant prognostic information regarding HF risk in all BMI categories, supporting its use for HF prediction even among those with obesity.


Embedded Image
  • Heart failure
  • Obesity
  • Author Disclosures: C.E. Ndumele: None. K. Matsushita: None. Y. Sang: None. M. Lazo: None. S.K. Agarwal: None. V. Nambi: H. Other; Modest; Co-investigator on a provisional patent that has been filed by Roche for the use of biomarkers in heart failure. A. Deswal: None. R.S. Blumenthal: None. C.M. Ballantyne: H. Other; Modest; Co-investigator on a provisional patent that has been filed by Roche for the use of biomarkers in heart failure. J. Coresh: None. E. Selvin: None.

  • © 2014 by American Heart Association, Inc.
Back to top
Previous Article

This Issue

Circulation
March 25, 2014, Volume 129, Issue Suppl 1
  • Table of Contents
Previous Article

Jump to

  • Article
  • Info & Metrics

Article Tools

  • Citation Tools
    Abstract P021: NT-proBNP Predicts Incident Heart Failure Among Individuals in All BMI Categories
    Chiadi E Ndumele, Kunihiro Matsushita, Yingying Sang, Mariana Lazo, Sunil K Agarwal, Vijay Nambi, Anita Deswal, Roger S Blumenthal, Christie M Ballantyne, Josef Coresh and Elizabeth Selvin
    Circulation. 2014;129:AP021, originally published March 19, 2014

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero
  • Article Alerts
    Log in to Email Alerts with your email address.
  • Save to my folders

Share this Article

  • Email

    Thank you for your interest in spreading the word on Circulation.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    Abstract P021: NT-proBNP Predicts Incident Heart Failure Among Individuals in All BMI Categories
    (Your Name) has sent you a message from Circulation
    (Your Name) thought you would like to see the Circulation web site.
  • Share on Social Media
    Abstract P021: NT-proBNP Predicts Incident Heart Failure Among Individuals in All BMI Categories
    Chiadi E Ndumele, Kunihiro Matsushita, Yingying Sang, Mariana Lazo, Sunil K Agarwal, Vijay Nambi, Anita Deswal, Roger S Blumenthal, Christie M Ballantyne, Josef Coresh and Elizabeth Selvin
    Circulation. 2014;129:AP021, originally published March 19, 2014
    del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo

Related Articles

Cited By...

Circulation

  • About Circulation
  • Instructions for Authors
  • Circulation CME
  • Statements and Guidelines
  • Meeting Abstracts
  • Permissions
  • Journal Policies
  • Email Alerts
  • Open Access Information
  • AHA Journals RSS
  • AHA Newsroom

Editorial Office Address:
200 Fifth Avenue, Suite 1020
Waltham, MA 02451
email: circ@circulationjournal.org
 

Information for:
  • Advertisers
  • Subscribers
  • Subscriber Help
  • Institutions / Librarians
  • Institutional Subscriptions FAQ
  • International Users
American Heart Association Learn and Live
National Center
7272 Greenville Ave.
Dallas, TX 75231

Customer Service

  • 1-800-AHA-USA-1
  • 1-800-242-8721
  • Local Info
  • Contact Us

About Us

Our mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. The need for our work is beyond question. Find Out More about the American Heart Association

  • Careers
  • SHOP
  • Latest Heart and Stroke News
  • AHA/ASA Media Newsroom

Our Sites

  • American Heart Association
  • American Stroke Association
  • For Professionals
  • More Sites

Take Action

  • Advocate
  • Donate
  • Planned Giving
  • Volunteer

Online Communities

  • AFib Support
  • Garden Community
  • Patient Support Network
  • Professional Online Network

Follow Us:

  • Follow Circulation on Twitter
  • Visit Circulation on Facebook
  • Follow Circulation on Google Plus
  • Follow Circulation on Instagram
  • Follow Circulation on Pinterest
  • Follow Circulation on YouTube
  • Rss Feeds
  • Privacy Policy
  • Copyright
  • Ethics Policy
  • Conflict of Interest Policy
  • Linking Policy
  • Diversity
  • Careers

©2018 American Heart Association, Inc. All rights reserved. Unauthorized use prohibited. The American Heart Association is a qualified 501(c)(3) tax-exempt organization.
*Red Dress™ DHHS, Go Red™ AHA; National Wear Red Day ® is a registered trademark.

  • PUTTING PATIENTS FIRST National Health Council Standards of Excellence Certification Program
  • BBB Accredited Charity
  • Comodo Secured