NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke
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NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke. / Di Castelnuovo, Augusto; Veronesi, Giovanni; Costanzo, Simona; Zeller, Tanja; Schnabel, Renate B; de Curtis, Amalia; Salomaa, Veikko; Borchini, Rossana; Ferrario, Marco; Giampaoli, Simona; Kee, Frank; Söderberg, Stefan; Niiranen, Teemu; Kuulasmaa, Kari; de Gaetano, Giovanni; Donati, Maria Benedetta; Blankenberg, Stefan; Iacoviello, Licia; BiomarCaRE Investigators.
in: STROKE, Jahrgang 50, Nr. 3, 03.2019, S. 610-617.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - NT-proBNP (N-Terminal Pro-B-Type Natriuretic Peptide) and the Risk of Stroke
AU - Di Castelnuovo, Augusto
AU - Veronesi, Giovanni
AU - Costanzo, Simona
AU - Zeller, Tanja
AU - Schnabel, Renate B
AU - de Curtis, Amalia
AU - Salomaa, Veikko
AU - Borchini, Rossana
AU - Ferrario, Marco
AU - Giampaoli, Simona
AU - Kee, Frank
AU - Söderberg, Stefan
AU - Niiranen, Teemu
AU - Kuulasmaa, Kari
AU - de Gaetano, Giovanni
AU - Donati, Maria Benedetta
AU - Blankenberg, Stefan
AU - Iacoviello, Licia
AU - BiomarCaRE Investigators
PY - 2019/3
Y1 - 2019/3
N2 - Background and Purpose- NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a risk factor for atrial fibrillation and a marker of cardiac function used in the detection of heart failure. Given the link between cardiac dysfunction and stroke, NT-proBNP is a candidate marker of stroke risk. Our aim was to evaluate the association of NT-proBNP with stroke and to determine the predictive value beyond a panel of established risk factors. Methods- Based on the Biomarkers for Cardiovascular Risk Assessment in Europe-Consortium, we analyzed data of 58 173 participants (50% men; mean age 52 y) free of stroke from 6 community-based cohorts. NT-proBNP measurements were performed in the central Biomarkers for Cardiovascular Risk Assessment in Europe laboratory. The outcomes considered were total stroke and subtypes of stroke (ischemic/hemorrhagic). Results- During a median follow-up time of 7.9 years, we observed 1550 stroke events (1176 ischemic). Increasing quarters of the NT-proBNP distribution were associated with increasing risk of stroke ( P for trend <0.0001; multivariable Cox regression analysis adjusted for risk factors and cardiac diseases). Individuals in the highest NT-proBNP quarter (NT-proBNP >82.2 pg/mL) had 2-fold (95% CI, 75%-151%) greater risk of stroke than individuals in the lowest quarter (NT-proBNP <20.4 pg/mL). The association remained unchanged when adjusted for interim coronary events during follow-up, and though it was somewhat heterogeneous across cohorts, it was highly homogenous according to cardiovascular risk profile or subtypes of stroke. The addition of NT-proBNP to a reference model increased the C-index discrimination measure by 0.006 ( P=0.0005), yielded a categorical net reclassification improvement of 2.0% in events and 1.4% in nonevents and an integrated discrimination improvement of 0.007. Conclusions- In European individuals free of stroke, levels of NT-proBNP are positively associated with risk of ischemic and hemorrhagic stroke, independently from several other risk factors and conditions. The addition of NT-proBNP to variables of established risk scores improves prediction of stroke, with a medium effect size.
AB - Background and Purpose- NT-proBNP (N-terminal pro-B-type natriuretic peptide) is a risk factor for atrial fibrillation and a marker of cardiac function used in the detection of heart failure. Given the link between cardiac dysfunction and stroke, NT-proBNP is a candidate marker of stroke risk. Our aim was to evaluate the association of NT-proBNP with stroke and to determine the predictive value beyond a panel of established risk factors. Methods- Based on the Biomarkers for Cardiovascular Risk Assessment in Europe-Consortium, we analyzed data of 58 173 participants (50% men; mean age 52 y) free of stroke from 6 community-based cohorts. NT-proBNP measurements were performed in the central Biomarkers for Cardiovascular Risk Assessment in Europe laboratory. The outcomes considered were total stroke and subtypes of stroke (ischemic/hemorrhagic). Results- During a median follow-up time of 7.9 years, we observed 1550 stroke events (1176 ischemic). Increasing quarters of the NT-proBNP distribution were associated with increasing risk of stroke ( P for trend <0.0001; multivariable Cox regression analysis adjusted for risk factors and cardiac diseases). Individuals in the highest NT-proBNP quarter (NT-proBNP >82.2 pg/mL) had 2-fold (95% CI, 75%-151%) greater risk of stroke than individuals in the lowest quarter (NT-proBNP <20.4 pg/mL). The association remained unchanged when adjusted for interim coronary events during follow-up, and though it was somewhat heterogeneous across cohorts, it was highly homogenous according to cardiovascular risk profile or subtypes of stroke. The addition of NT-proBNP to a reference model increased the C-index discrimination measure by 0.006 ( P=0.0005), yielded a categorical net reclassification improvement of 2.0% in events and 1.4% in nonevents and an integrated discrimination improvement of 0.007. Conclusions- In European individuals free of stroke, levels of NT-proBNP are positively associated with risk of ischemic and hemorrhagic stroke, independently from several other risk factors and conditions. The addition of NT-proBNP to variables of established risk scores improves prediction of stroke, with a medium effect size.
KW - Adult
KW - Atrial Fibrillation/complications
KW - Biomarkers
KW - Brain Ischemia/blood
KW - Cohort Studies
KW - Europe/epidemiology
KW - Female
KW - Humans
KW - Intracranial Hemorrhages/blood
KW - Male
KW - Middle Aged
KW - Natriuretic Peptide, Brain/blood
KW - Peptide Fragments/blood
KW - Predictive Value of Tests
KW - Risk Factors
KW - Sex Factors
KW - Stroke/blood
KW - Treatment Outcome
U2 - 10.1161/STROKEAHA.118.023218
DO - 10.1161/STROKEAHA.118.023218
M3 - SCORING: Journal article
C2 - 30786848
VL - 50
SP - 610
EP - 617
JO - STROKE
JF - STROKE
SN - 0039-2499
IS - 3
ER -