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Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study
BACKGROUND: The prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) across body mass index (BMI) categories in patients with acute myocardial infarction (AMI) is unclear. We aimed to assess the predictive value of NT-proBNP levels and identify the best cutoff values for mortali...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557200/ https://www.ncbi.nlm.nih.gov/pubmed/37798776 http://dx.doi.org/10.1186/s13098-023-01163-1 |
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author | Wang, Man Cao, Ning Zhou, Li Su, Wen Chen, Hui Li, Hongwei |
author_facet | Wang, Man Cao, Ning Zhou, Li Su, Wen Chen, Hui Li, Hongwei |
author_sort | Wang, Man |
collection | PubMed |
description | BACKGROUND: The prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) across body mass index (BMI) categories in patients with acute myocardial infarction (AMI) is unclear. We aimed to assess the predictive value of NT-proBNP levels and identify the best cutoff values for mortality risk prediction across BMI categories in AMI. METHODS: We analyzed 4677 patients with AMI from the Cardiovascular Centre Beijing Friendship Hospital Database Bank. Patients were classified into underweight (< 18.5 kg/m(2)), normal-weight (18.5–23.9 kg/m(2)), overweight (24–27.9 kg/m(2)), and obese (≥ 28 kg/m(2)) groups. The association between NT-proBNP (ln-transformed) and mortality was investigated using Cox regression and stratified by BMI. RESULTS: During follow-up (13,787 person-years of observation), 718 patients died, averaging 52.1 events per 1000 person-years. NT-proBNP levels were inversely correlated with BMI (β = − 0.096, P < 0.001). After adjustment, NT-proBNP was independently associated with all-cause mortality (hazard ratio [HR] per 1-SD: 1.82; 95% confidence interval [CI] 1.60–2.07) in patients with AMI. Similar findings were observed in analyses stratified by BMI category, except for the underweight group. Adding NT-proBNP to conventional risk models improved risk discrimination in normal-weight, overweight, and obese patients (C-index changes of 0.036, 0.042, and 0.032, respectively) and classification of patients into predicted mortality risk categories (net reclassification improvement 0.263, 0.204, and 0.197, respectively). The best NT-proBNP cutoff values for 5-year mortality risk prediction across BMI categories were 5710, 4492, 2253, and 1300 pg/ml. CONCLUSION: NT-proBNP level was an independent prognostic factor for mortality in patients with AMI and varied according to BMI. The best NT-proBNP cutoff values for mortality risk prediction reduced as BMI increased. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-023-01163-1. |
format | Online Article Text |
id | pubmed-10557200 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105572002023-10-07 Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study Wang, Man Cao, Ning Zhou, Li Su, Wen Chen, Hui Li, Hongwei Diabetol Metab Syndr Research BACKGROUND: The prognostic value of N-terminal pro-B-type natriuretic peptide (NT-proBNP) across body mass index (BMI) categories in patients with acute myocardial infarction (AMI) is unclear. We aimed to assess the predictive value of NT-proBNP levels and identify the best cutoff values for mortality risk prediction across BMI categories in AMI. METHODS: We analyzed 4677 patients with AMI from the Cardiovascular Centre Beijing Friendship Hospital Database Bank. Patients were classified into underweight (< 18.5 kg/m(2)), normal-weight (18.5–23.9 kg/m(2)), overweight (24–27.9 kg/m(2)), and obese (≥ 28 kg/m(2)) groups. The association between NT-proBNP (ln-transformed) and mortality was investigated using Cox regression and stratified by BMI. RESULTS: During follow-up (13,787 person-years of observation), 718 patients died, averaging 52.1 events per 1000 person-years. NT-proBNP levels were inversely correlated with BMI (β = − 0.096, P < 0.001). After adjustment, NT-proBNP was independently associated with all-cause mortality (hazard ratio [HR] per 1-SD: 1.82; 95% confidence interval [CI] 1.60–2.07) in patients with AMI. Similar findings were observed in analyses stratified by BMI category, except for the underweight group. Adding NT-proBNP to conventional risk models improved risk discrimination in normal-weight, overweight, and obese patients (C-index changes of 0.036, 0.042, and 0.032, respectively) and classification of patients into predicted mortality risk categories (net reclassification improvement 0.263, 0.204, and 0.197, respectively). The best NT-proBNP cutoff values for 5-year mortality risk prediction across BMI categories were 5710, 4492, 2253, and 1300 pg/ml. CONCLUSION: NT-proBNP level was an independent prognostic factor for mortality in patients with AMI and varied according to BMI. The best NT-proBNP cutoff values for mortality risk prediction reduced as BMI increased. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13098-023-01163-1. BioMed Central 2023-10-06 /pmc/articles/PMC10557200/ /pubmed/37798776 http://dx.doi.org/10.1186/s13098-023-01163-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Wang, Man Cao, Ning Zhou, Li Su, Wen Chen, Hui Li, Hongwei Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study |
title | Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study |
title_full | Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study |
title_fullStr | Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study |
title_full_unstemmed | Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study |
title_short | Association of N-terminal pro-B-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study |
title_sort | association of n-terminal pro-b-type natriuretic peptide levels and mortality risk in acute myocardial infarction across body mass index categories: an observational cohort study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10557200/ https://www.ncbi.nlm.nih.gov/pubmed/37798776 http://dx.doi.org/10.1186/s13098-023-01163-1 |
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