Key result
A higher NT-proBNP level was significantly associated with increased all-cause mortality in heart failure patients with a BMI < 23 kg/m2 (HR 2.24), but not in those with a BMI ≥ 23 kg/m2.
Why the study?
Despite an inverse correlation between NT-proBNP and BMI, the impact of BMI on the prognostic value of NT-proBNP has not been well addressed.
Does BMI impact the prognostic value of NT-proBNP for all-cause mortality and HF readmission in patients hospitalized for acute heart failure?
Cohort (n=1,877)
Yes
Does BMI impact the prognostic value of NT-proBNP for all-cause mortality and HF readmission in patients hospitalized for acute heart failure?
Hazard Ratio: 2.24 (95% CI 1.54–3.25)
p-value: p=<0.001
In patients with acute heart failure, higher NT-proBNP levels are associated with increased risk of mortality and HF readmission across both nonobese and overweight/obese BMI categories in unadjusted analyses.
BMI may modify NT-proBNP prognostic value in acute HF; leaves open whether BMI-adjusted cutoffs refine risk stratification.
Background and Objectives: Although an inverse correlation between the level of amino (N)-terminal pro-brain natriuretic peptide (NT-proBNP) and body mass index (BMI) has been reported, the impact of BMI on the prognostic value of NT-proBNP has not been well addressed. Methods: A total of 1,877 patients (67-year-old and 49.9% females) hospitalized for acute heart failure (HF) with documented NT-proBNP levels at baseline were included. Patients were classified into 2 groups by BMI (nonobese: BMI<23 kg/m 2 and overweight or obese: BMI23 kg/m 2 ). Clinical events during the follow-up including all-cause mortality and HF readmission were assessed. Results: During the median follow-up of 828 days (interquartile range, 111-1,514 days), there were 595 cases of total mortality (31.7%), 600 cases of HF readmission (32.0%), and 934 cases of composite events (49.8%). In unadjusted analyses, higher NT-proBNP level was associated with all-cause mortality and composite events (all-cause mortality and HF readmission) in both patients with BMI<23 kg/m 2 and those with BMI23 kg/m 2 . In adjusted analyses controlling for potential confounders, however, a higher NT-proBNP level was
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Kim et al. (2020) conducted a cohort in Acute heart failure (n=1,877). Higher NT-proBNP level (highest tertile) vs. Lowest NT-proBNP tertile was evaluated on All-cause mortality in patients with BMI < 23 kg/m2 (HR 2.24, 95% CI 1.54-3.25, p=<0.001). A higher NT-proBNP level was significantly associated with increased all-cause mortality in heart failure patients with a BMI < 23 kg/m2 (HR 2.24), but not in those with a BMI ≥ 23 kg/m2.
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