Key result
High NT-proANP links to ~96% greater HF risk, largely dependent on baseline cardiovascular morbidity.
Why the study?
Longitudinal data on the association between NT-proANP levels and major cardiovascular outcomes in subjects without cardiovascular disease were largely lacking.
Do higher NT-proANP levels predict HF events, CVD events, CVD mortality, and total mortality in middle-aged subjects with and without baseline CVD?
Cohort (n=1,044)
Do higher NT-proANP levels predict HF events, CVD events, CVD mortality, and total mortality in middle-aged subjects with and without baseline CVD?
The prognostic value of NT-proANP for cardiovascular outcomes over 31 years depends heavily on baseline cardiovascular morbidity, with stronger predictive value in those with pre-existing CVD.
NT-proANP should not yet guide HF risk stratification without baseline CVD; leaves open its incremental value in secondary prevention cohorts.
In subjects with cardiovascular disease (CVD), higher N-terminal proatrial natriuretic peptide (NT-proANP) are associated with major cardiovascular outcomes, while in subjects without CVDs longitudinal data is largely lacking. Our aim was to assess cross-sectional associations between NT-proANP and key CVD factors (1044 subjects, 40-62 years, 51% hypertensive, 49% males) and to evaluate the predictive potential of NT-proANP for HF events, CVD events, CVD mortality, and total mortality over an up-to 31-year follow-up period. In subjects with CVDs, the high NT-proANP tertile had decreased kidney function, higher prevalence of CVDs and adverse echocardiographic measures but also the lowest fasting insulin levels, and in longitudinal analysis had an increased risk for HF events and CVD mortality. In subjects without CVDs the high NT-proANP tertile had the healthiest metabolic profile with the lowest BMI, fasting insulin levels and blood pressure, and in longitudinal analysis weaker evidence for increased risk for HF events and CVD mortality were observed. Regardless of CVDs, NT-proANP levels increased with age and were not independently associated with total mortality. In this middle-aged population, followed for up to three decades, the cross-sectional and longitudinal associations of NT-proANP levels were largely dependent on population characteristics such as age and CVDs.
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Sakko et al. (2025) conducted a cohort in Cardiovascular disease risk (n=1,044). High NT-proANP levels (Tertile 3) vs. Low NT-proANP levels (Tertile 1) was evaluated on Heart failure events (HR 1.96, 95% CI 1.05-3.67). High NT-proANP levels were associated with an increased risk of heart failure events (HR 1.96) over a 31-year follow-up, with prognostic value largely dependent on baseline cardiovascular morbidity.
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