Key result
Elevated NT-proBNP levels (>480 ng/L) were significantly associated with an increased risk of carotid artery plaque compared to levels <56 ng/L in patients with coronary heart disease (OR 1.67).
Why the study?
Studies on the association and diagnostic value of NT-proBNP in carotid plaques in patients with coronary heart disease are limited.
Does elevated NT-proBNP correlate with an increased risk of carotid artery plaque in patients with coronary heart disease?
Cohort (n=5,093)
Yes
Does elevated NT-proBNP correlate with an increased risk of carotid artery plaque in patients with coronary heart disease?
Elevated NT-proBNP levels are independently associated with an increased risk of carotid artery plaque in patients with coronary heart disease, particularly in males, older patients, and those with abnormal glucose metabolism.
Should not yet change CHD management; extends NT-proBNP-plaque associations but requires prospective validation.
OBJECTIVE: Circulating N-terminal pro B-type natriuretic peptide (NT-proBNP) is a marker for heart failure in patients with coronary heart disease (CHD) and associated with glycemic abnormalities. Studies on the association and diagnostic value of NT-proBNP in carotid plaques (CAP) in patients with CHD are limited. METHODS: The relationships between NT-proBNP and the risk of CAP in different glucose metabolic states, sexes, and age categories were also examined using 5,093 patients diagnosed with CHD. The NT-proBNP tertiles were used to divide patients into three groups in which the NT-proBNP levels, blood glucose levels, the occurrence of CAP, and the number and nature of CAP were measured using normoglycemic (NG), prediabetes (Pre-DM), and diabetes mellitus (DM) glucose metabolic statuses. Logistic regression analyses were used to compare the relationship between NT-proBNP and the risk of CAP occurrence and the number and nature of CAP. The diagnostic value of NT-proBNP for CAP risk was measured using receiver operating characteristic (ROC) curves. RESULTS: We found a 37% relative increase in the correlation between changes in NT-proBNP per standard deviation (SD) and the incidence of CAP. After adjusting for potential confounders, NT-proBNP at the T3 level was found to be associated with an increased CAP odds ratio (OR) when T1 was used as the reference. This relationship was also present in males, patients aged > 60 years, or both pre-DM and DM states. NT-proBNP was more likely to present as hypoechoic plaques at T1 and as mixed plaques at T3. We also measured the diagnostic accuracy of CAP for NT-proBNP in patients with CHD, with an AUC value of 0.627(95% CI 0.592-0.631), sensitivity of 50.7%, and specificity of 68.0%. CONCLUSION: An increase in NT-proBNP was significantly associated with the risk of CAP in patients with CHD, especially in males and patients aged > 60 years, and exhibited specific characteristics under different glucose metabolism states. Trial registration The study was approved by the Ethics Committee of Tianjin University of Traditional Chinese Medicine (Approval number TJUTCM-EC20210007) and certified by the Chinese Clinical Trials Registry on April 4, 2022 (Registration number ChiCTR2200058296) and March 25, 2022 by ClinicalTrials.gov (registration number NCT05309343).
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Yang et al. (2023) conducted a cohort in Coronary heart disease (n=5,093). Elevated NT-proBNP (> 480 ng/L) vs. Low NT-proBNP (< 56 ng/L) was evaluated on Risk of carotid artery plaque (OR 1.67, 95% CI 1.26-2.22, p=<0.001). Elevated NT-proBNP levels (>480 ng/L) were significantly associated with an increased risk of carotid artery plaque compared to levels <56 ng/L in patients with coronary heart disease (OR 1.67).
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