N-terminal pro-B-type natriuretic peptide is not a significant predictor of stroke incidence after 5 years ― The Ohasama study ―

Michihiro Satoh, Takahisa Murakami, Kei Asayama, Takuo Hirose, Masahiro Kikuya, Ryusuke Inoue, Megumi Tsubota-Utsugi, Keiko Murakami, Ayako Matsuda, Azusa Hara, Taku Obara, Ryo Kawasaki, Kyoko Nomura, Hirohito Metoki, Koichi Node, Yutaka Imai, Takayoshi Ohkubo

Research output: Contribution to journalArticle

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Abstract

Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point. Methods and Results: We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. Conclusions: NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.

Original languageEnglish
Pages (from-to)2055-2062
Number of pages8
JournalCirculation Journal
Volume82
Issue number8
DOIs
Publication statusPublished - 2018 Jan 1
Externally publishedYes

Fingerprint

Brain Natriuretic Peptide
Stroke
Incidence
Acute Coronary Syndrome
Heart Failure

Keywords

  • Epidemiology
  • N-terminal pro-B-type natriuretic peptide
  • Prevention
  • Stroke

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

N-terminal pro-B-type natriuretic peptide is not a significant predictor of stroke incidence after 5 years ― The Ohasama study ―. / Satoh, Michihiro; Murakami, Takahisa; Asayama, Kei; Hirose, Takuo; Kikuya, Masahiro; Inoue, Ryusuke; Tsubota-Utsugi, Megumi; Murakami, Keiko; Matsuda, Ayako; Hara, Azusa; Obara, Taku; Kawasaki, Ryo; Nomura, Kyoko; Metoki, Hirohito; Node, Koichi; Imai, Yutaka; Ohkubo, Takayoshi.

In: Circulation Journal, Vol. 82, No. 8, 01.01.2018, p. 2055-2062.

Research output: Contribution to journalArticle

Satoh, M, Murakami, T, Asayama, K, Hirose, T, Kikuya, M, Inoue, R, Tsubota-Utsugi, M, Murakami, K, Matsuda, A, Hara, A, Obara, T, Kawasaki, R, Nomura, K, Metoki, H, Node, K, Imai, Y & Ohkubo, T 2018, 'N-terminal pro-B-type natriuretic peptide is not a significant predictor of stroke incidence after 5 years ― The Ohasama study ―', Circulation Journal, vol. 82, no. 8, pp. 2055-2062. https://doi.org/10.1253/circj.CJ-17-1227
Satoh, Michihiro ; Murakami, Takahisa ; Asayama, Kei ; Hirose, Takuo ; Kikuya, Masahiro ; Inoue, Ryusuke ; Tsubota-Utsugi, Megumi ; Murakami, Keiko ; Matsuda, Ayako ; Hara, Azusa ; Obara, Taku ; Kawasaki, Ryo ; Nomura, Kyoko ; Metoki, Hirohito ; Node, Koichi ; Imai, Yutaka ; Ohkubo, Takayoshi. / N-terminal pro-B-type natriuretic peptide is not a significant predictor of stroke incidence after 5 years ― The Ohasama study ―. In: Circulation Journal. 2018 ; Vol. 82, No. 8. pp. 2055-2062.
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abstract = "Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point. Methods and Results: We followed 1,198 participants (33.4{\%} men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95{\%} CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95{\%} CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. Conclusions: NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.",
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AU - Satoh, Michihiro

AU - Murakami, Takahisa

AU - Asayama, Kei

AU - Hirose, Takuo

AU - Kikuya, Masahiro

AU - Inoue, Ryusuke

AU - Tsubota-Utsugi, Megumi

AU - Murakami, Keiko

AU - Matsuda, Ayako

AU - Hara, Azusa

AU - Obara, Taku

AU - Kawasaki, Ryo

AU - Nomura, Kyoko

AU - Metoki, Hirohito

AU - Node, Koichi

AU - Imai, Yutaka

AU - Ohkubo, Takayoshi

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point. Methods and Results: We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. Conclusions: NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.

AB - Background: N-terminal pro-B-type natriuretic peptide (NT-proBNP) has been used for risk stratification in heart failure or acute coronary syndrome, but the beyond 5-year predictive value of NT-proBNP for stroke remains an unsettled issue in Asian patients. The aim of the present study was to clarify this point. Methods and Results: We followed 1,198 participants (33.4% men; mean age, 60.5±11.1 years old) in the Japanese general population for a median of 13.0 years. A first stroke occurred in 93 participants. Referencing previous reports, we stratified participants according to NT-proBNP 30.0, 55.0, and 125.0 pg/mL. Using the NT-proBNP <30.0 pg/mL group as a reference, adjusted HR for stroke (95% CI) in the NT-proBNP 30.0–54.9-pg/mL, 55.0–124.9-pg/mL, and ≥125.0-pg/mL groups were 1.92 (0.94–3.94), 1.77 (0.85–3.66), and 1.99 (0.86–4.61), respectively. With the maximum follow-up period set at 5 years, the hazard ratio of the NT-proBNP≥125.0-pg/mL group compared with the <30.0-pg/mL group increased significantly (HR, 4.51; 95% CI: 1.03–19.85). On extension of the maximum follow-up period, however, the association between NT-proBNP and stroke risk weakened. Conclusions: NT-proBNP was significantly associated with an elevated stroke risk. Given, however, that the predictive power decreased with the number of years after NT-proBNP measurement, NT-proBNP should be re-evaluated periodically in Asian patients.

KW - Epidemiology

KW - N-terminal pro-B-type natriuretic peptide

KW - Prevention

KW - Stroke

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