Relation of N-terminal pro-brain natriuretic peptide levels and their prognostic power in chronic stable heart failure to obesity status
Eur Heart J 2008; 29: 2634–2640 View citation
Aims: To investigate the relationship between body mass index (BMI) and N-terminal pro-brain natriuretic peptide (NTproBNP) level and resultant prognostic capacity in chronic heart failure (CHF) controlled for known confounders.
Methods and results:30 kg/m2 (group 3), 20–24.9 kg/m2 (group 1), and 25–29.9 kg/m2 (group 2). BMI conveys a 4% drop in NTproBNP per unit increase. This influence remained significant after correction for age, sex, MDRD, NYHA, heart rate, rhythm, and ejection fraction. NTproBNP remained an independent predictor of adverse outcome after correction for age, sex, BMI, NYHA, MDRD, and ejection fraction. Despite numerical differences, prognostic power was comparable between BMI groups (log-transformed NTproBNP; group 1: hazard ratio (HR) 1.435, 95% CI 1.046–1.967, 2 5.02, P = 0.03; group 2: HR 1.604, 95% CI 1.203–2.138, 2 10.36, P = 0.001; group 3: HR 1.735, 95% CI 1.302–2.313, 2 14.12, P = 0.0002) (P = NS, all). An NTproBNP correction factor was calculated.
Conclusion: Even matched for NYHA, age, sex, and renal function, BMI exerts a significant and independent inverse influence on NTproBNP in patients with stable CHF. NTproBNP retained equal statistical power in all three BMI groups.
