Abstract 19648: Amino-Terminal Pro-Brain Natriuretic Peptide Improves Risk Stratification in Asymptomatic Individuals at Very High Risk of Future Cardiovascular Events
Background: In the general population, screening for risk of future cardiovascular events is performed using established risk scores based on traditional risk factors. Previous studies suggest that amino-terminal pro-brain natriuretic peptide (NT-proBNP) may provide additional prognostic information on incident cardiovascular events in the general population.
Aim: This study investigated whether NT-proBNP could improve risk prediction among asymptomatic individuals with a very high risk of future cardiovascular events (Framingham risk score ≥30%).
Methods: Middle-age and older participants with no history of cardiovascular disease or heart failure were recruited from the general population (n=1244, mean age 64.9±10.2 years, 69% male). Fatal/non-fatal cardiovascular events were recorded over 5 years follow-up. Associations between plasma NT-proBNP at baseline, Framingham risk score and cardiovascular events were tested with Cox regression and log-rank tests.
Results: A total of 194 (16%) participants experienced a fatal/non-fatal cardiovascular event within 5 years. For all participants, higher levels of NT-proBNP were strongly associated with fatal/non-fatal cardiovascular events (event rates for NT-proBNP tertiles: 6%, 13%, 27% log-rank p<0.001). This association was independent of the Framingham risk score (p<0.001). The majority of events (117 events, 60%) occurred among participants with a Framingham risk score ≥30% (380 participants), among whom NT-proBNP conferred an even greater prognostic advantage: those with the highest NT-proBNP levels were at markedly increased risk (event rates for NT-proBNP tertiles: 17%, 28%, 38%, log-rank p=0.006, Figure 1).
Conclusions: These data suggest that plasma NT-proBNP may significantly improve risk stratification among asymptomatic individuals of middle-older age identified as having a very high risk of future cardiovascular events according to established risk scores.
Author Disclosures: A.P. Pilbrow: None. C.M. Frampton: None. A.M. Richards: None. R.W. Troughton: None. V.A. Cameron: None.
- © 2014 by American Heart Association, Inc.