Key result
Each log-transformed SD increment in N-terminal proA-type natriuretic peptide was associated with a 1.35-fold increased risk of any stroke (95% CI 1.01-1.84; p=0.049) in men.
Why the study?
Do plasma N-terminal fragments of natriuretic peptides predict the risk of stroke and atrial fibrillation in men?
Cohort (n=958)
Do plasma N-terminal fragments of natriuretic peptides predict the risk of stroke and atrial fibrillation in men?
Relative Risk: 1.35 (95% CI 1.01–1.84)
p-value: p=0.049
Elevated levels of NT-proANP and NT-proBNP are independent predictors of future stroke and atrial fibrillation in middle-aged men.
May refine stroke risk assessment in men; extends observational data on NT-proANP but leaves open incremental utility.
BACKGROUND: Risk stratification for cardiovascular outcomes is gaining importance in general population. Prognostic value of natriuretic peptides has been established in patients with heart failure. However, the prognostic significance of natriuretic peptides with respect to stroke is not well known in general populations. METHODS: Plasma natriuretic peptides were measured in a representative population-based sample of 958 men (age 46-65 years) from Eastern Finland. There were 46 cases of stroke, 74 of atrial fibrillation and 31 cases of ischaemic strokes during a follow-up of 9.6 years. RESULTS: The multivariable adjusted risk was 1.35-fold (95% CI 1.01 to 1.84, p = 0.049) for any stroke and 1.30-fold (95% CI 0.90 to 1.91, p = 0.0150) for ischaemic stroke for each log-transformed SD (0.240 pmol/l) increment in N-terminal fragment of proA-type natriuretic peptide. The respective risks were 1.36-fold (95% CI 1.05 to 1.76, p = 0.010) and 1.50-fold (95% CI 1.12 to 2.02, p = 0.007) for each log-transformed SD (0.237 pmol/l) increment in N-terminal fragment of proB-type natriuretic peptide. The multivariate adjusted risks for future atrial fibrillation were 1.71 (95% CI 1.32 to 2.22, p<0.001) and 1.68-fold (95% CI 1.38 to 2.07, p<0.001) for each log-transformed SD increment in N-terminal fragments of proA- and proB-type natriuretic peptides, respectively. CONCLUSIONS: N-terminal fragments of pro-atrial natriuretic peptide and pro-brain natriuretic peptide are new additional predictors of any stroke and atrial fibrillation. Natriuretic peptides provide prognostic information for stroke and atrial fibrillation and may help in identifying subjects at risk for stroke and atrial fibrillation.
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Kurl et al. (2009) conducted a cohort in General population (n=958). Plasma N-terminal fragments of natriuretic peptides vs. Lower levels (per log-transformed SD increment) was evaluated on Any stroke (RR 1.35, 95% CI 1.01-1.84, p=0.049). Each log-transformed SD increment in N-terminal proA-type natriuretic peptide was associated with a 1.35-fold increased risk of any stroke (95% CI 1.01-1.84; p=0.049) in men.
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