Key result
NT-proBNP levels ≥125.0 pg/mL significantly increased the 5-year risk of stroke compared to levels <30.0 pg/mL (HR 4.51) in a Japanese general population, but this association weakened beyond 5 years.
Why the study?
Does elevated NT-proBNP predict first stroke incidence in a general Asian population without prior cardiovascular disease?
Cohort (n=1,198)
No
Does elevated NT-proBNP predict first stroke incidence in a general Asian population without prior cardiovascular disease?
Effect estimate: HR 4.51 (95% CI 1.03-19.85)
p-value: p=0.046
NT-proBNP is a significant predictor of stroke risk within a 5-year horizon in the general Asian population, but its predictive value diminishes over longer follow-up periods, suggesting the need for periodic reassessment.
NT-proBNP may aid short-term stroke risk stratification in Asian adults without CVD; leaves open longer-term utility and need for validation.
BACKGROUND: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point. METHODS AND RESULTS: We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0-54.9-pg/mL, 55.0-124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94-3.94), 1.77 (0.85-3.66), and 1.99 (0.86-4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03-19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. CONCLUSIONS: NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.
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Satoh et al. (2018) conducted a cohort in Stroke risk in the general population (n=1,198). NT-proBNP ≥125.0 pg/mL vs. NT-proBNP <30.0 pg/mL was evaluated on First stroke incidence within 5 years (HR 4.51, 95% CI 1.03-19.85, p=0.046). NT-proBNP levels ≥125.0 pg/mL significantly increased the 5-year risk of stroke compared to levels <30.0 pg/mL (HR 4.51) in a Japanese general population, but this association weakened beyond 5 years.
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