Key result
Higher urinary NT-proBNP concentrations (≥ 43 pg/mL) were associated with a doubled risk of developing cardiovascular disease compared to lower concentrations (≤ 19 pg/mL) (HR 2.07).
Why the study?
Serum NT-proBNP is linked to cardiovascular risk, and because it is excreted in urine, urinary NT-proBNP was hypothesized to correlate with serum levels and cardiovascular risk in the general population.
Does elevated urinary NT-proBNP predict cardiovascular events in a general population?
Cohort (n=3,060)
No
Does elevated urinary NT-proBNP predict cardiovascular events in a general population?
Hazard Ratio: 2.07 (95% CI 1.2–3.56)
p-value: p=0.009
Urinary NT-proBNP concentrations correlate strongly with serum levels and independently predict future cardiovascular events in a general population, suggesting its potential as a noninvasive biomarker for CVD risk assessment.
May support urinary NT-proBNP for CVD risk stratification in community adults; leaves open incremental value beyond serum measures or established predictors.
BACKGROUND: Epidemiological evidence has shown that serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations, a diagnostic biomarker for heart failure, are positively associated with cardiovascular risk. Since NT-proBNP in serum is excreted in urine, it is hypothesized that urinary NT-proBNP concentrations are correlated with serum concentrations and linked with cardiovascular risk in the general population. METHODS: A total of 3060 community-dwelling residents aged ≥ 40 years without history of cardiovascular disease (CVD) were followed up for a median of 8.3 years (2007-2015). Serum and urinary concentrations of NT-proBNP at baseline were compared. The hazard ratios (HRs) and their 95% confidence intervals (CIs) for the association between NT-proBNP concentrations and the risk of developing CVD were computed using the Cox proportional hazards model. RESULTS: ] = 0.72): urinary concentrations of 20, 27, and 43 pg/mL were equivalent to serum concentrations of 55, 125, and 300 pg/mL, respectively. During the follow-up period, 170 subjects developed CVD. The age- and sex-adjusted risk of CVD increased significantly with higher urinary NT-proBNP levels (P for trend < 0.001). This association remained significant after adjustment for traditional cardiovascular risk factors (P for trend = 0.009). The multivariable-adjusted risk of developing CVD almost doubled in subjects with urinary NT-proBNP of ≥ 43 pg/mL as compared to those with urinary NT-proBNP of ≤ 19 pg/mL (HR 2.07, 95% CI 1.20-3.56). CONCLUSIONS: The present study demonstrated that urinary NT-proBNP concentrations were well-correlated with serum concentrations and were positively associated with cardiovascular risk. Given that urine sampling is noninvasive and does not require specially trained personnel, urinary NT-proBNP concentrations have the potential to be an easy and useful biomarker for detecting people at higher cardiovascular risk.
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Yamasaki et al. (2021) conducted a cohort in Cardiovascular disease risk (n=3,060). Urinary NT-proBNP concentrations ≥ 43 pg/mL vs. Urinary NT-proBNP concentrations ≤ 19 pg/mL was evaluated on Development of cardiovascular disease (first-ever episode of stroke or coronary heart disease) (HR 2.07, 95% CI 1.20-3.56, p=0.009). Higher urinary NT-proBNP concentrations (≥ 43 pg/mL) were associated with a doubled risk of developing cardiovascular disease compared to lower concentrations (≤ 19 pg/mL) (HR 2.07).
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